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Azziz-Baumgartner E, Hirsch A, Yoo YM, Peretz A, Greenberg D, Avni YS, Glatman-Freedman A, Mandelboim M, MacNeil A, Martin ET, Newes-Adeyi G, Thompson M, Monto AS, Balicer RD, Levine MZ, Katz MA. Incidence of laboratory-confirmed influenza and RSV and associated presenteeism and absenteeism among healthcare personnel, Israel, influenza seasons 2016 to 2019. Euro Surveill 2024; 29. [PMID: 39092531 PMCID: PMC11295438 DOI: 10.2807/1560-7917.es.2024.29.31.2300580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2024] Open
Abstract
BackgroundHealthcare personnel (HCP) are at high risk for respiratory infections through occupational exposure to respiratory viruses.AimWe used data from a prospective influenza vaccine effectiveness study in HCP to quantify the incidence of acute respiratory infections (ARI) and their associated presenteeism and absenteeism.MethodsAt the start and end of each season, HCP at two Israeli hospitals provided serum to screen for antibodies to influenza virus using the haemagglutination inhibition assay. During the season, active monitoring for the development of ARI symptoms was conducted twice a week by RT-PCR testing of nasal swabs for influenza and respiratory syncytial virus (RSV). Workplace presenteeism and absenteeism were documented. We calculated incidences of influenza- and RSV-associated ARI and applied sampling weights to make estimates representative of the source population.ResultsThe median age of 2,505 participating HCP was 41 years, and 70% were female. Incidence was 9.1 per 100 person-seasons (95% CI: 5.8-14.2) for RT-PCR-confirmed influenza and 2.5 per 100 person-seasons (95% CI: 0.9-7.1) for RSV illness. Each season, 18-23% of unvaccinated and influenza-negative HCP seroconverted. The incidence of seroconversion or RT-PCR-confirmed influenza was 27.5 per 100 person-seasons (95% CI: 17.8-42.5). Work during illness occurred in 92% (95% CI: 91-93) of ARI episodes, absence from work in 38% (95% CI: 36-40).ConclusionInfluenza virus and RSV infections and associated presenteeism and absenteeism were common among HCP. Improving vaccination uptake among HCP, infection control, and encouraging sick HCP to stay home are important strategies to reduce ARI incidence and decrease the risk of in-hospital transmission.
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Affiliation(s)
| | - Avital Hirsch
- Clalit Research Institute, Innovation Division, Clalit Health Services, Tel Aviv, Israel
| | - Young M Yoo
- United States Centers for Disease Control and Prevention (CDC), Atlanta, United States
| | - Alon Peretz
- Rabin Medical Center, Clalit Health Services, Petah Tikva, Israel
| | - David Greenberg
- Soroka University Medical Center, Clalit Health Services, Beersheba, Israel
| | - Yonat Shemer Avni
- Soroka University Medical Center, Clalit Health Services, Beersheba, Israel
| | - Aharona Glatman-Freedman
- School of Public Health, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel
- Israel Center for Disease Control, Ramat Gan, Israel
| | - Michal Mandelboim
- Central Virology Laboratory, Ministry of Health, Tel-Hashomer, Israel
- School of Public Health, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Adam MacNeil
- United States Centers for Disease Control and Prevention (CDC), Atlanta, United States
| | - Emily T Martin
- School of Public Health, University of Michigan, Ann Arbor, Michigan, United States
| | | | - Mark Thompson
- United States Centers for Disease Control and Prevention (CDC), Atlanta, United States
| | - Arnold S Monto
- School of Public Health, University of Michigan, Ann Arbor, Michigan, United States
| | - Ran D Balicer
- School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Be'er Sheva, Israel
- Clalit Research Institute, Innovation Division, Clalit Health Services, Tel Aviv, Israel
| | - Min Z Levine
- United States Centers for Disease Control and Prevention (CDC), Atlanta, United States
| | - Mark A Katz
- Clalit Research Institute, Innovation Division, Clalit Health Services, Tel Aviv, Israel
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Ibanes-Gutierrez C, Martínez-Rivera N, Martin-Onraet A, Rivera-Buendia F, Piñeirua-Menendez A, Villaseñor-Echavarri R, Serrano-Ortega J, Vilar-Compte D. SARS-CoV-2 infection in health care workers during the first 2-years of the pandemic at a cancer hospital in Mexico. Am J Infect Control 2024; 52:517-524. [PMID: 38103647 DOI: 10.1016/j.ajic.2023.12.004] [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: 08/19/2023] [Revised: 12/07/2023] [Accepted: 12/08/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Health care workers (HCWs) are occupationally exposed to severe acute respiratory syndrome coronavirus (SARS-CoV-2). This study aimed to characterize COVID-19 in HCWs at an oncology hospital in Mexico City over 2-years, identify factors associated with severity, and establish transmission dynamics. METHODS This retrospective study included HCWs with confirmed COVID-19. Socio-demographic, clinical, and outcome data were retrieved from March 2020 to March 2022. We compared the proportion of HCWs affected in each wave. A survey on COVID-19 transmission dynamics was conducted in a subgroup. RESULTS We included 1,058 workers. The risk of COVID-19 was higher during the Omicron odds ratio (OR 2.10, 95% confidence interval [CI] 1.77-2.50, P < .001). Age ≥41 years old (OR 6.32, 95% CI 2.4-16.62) and being administrative staff (OR 5.51, 95% CI 1.72-17.6) or medical staff (OR 6.82, CI 95% 1.77-26.23), compared to nursing staff, were associated with severity. Vaccination with ≥1 vaccine against SARS-CoV-2 was a protective factor for severe disease (OR 0.04, 95% CI 0.005-0.331). CONCLUSIONS This study highlights the impact of COVID-19 on HCWs in a cancer hospital in Mexico City and the impact of vaccination as a protective factor against severity.
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Affiliation(s)
| | | | | | - Frida Rivera-Buendia
- Clinical Research Department, Instituto Nacional de Cardiologia, Mexico & Health Research Consortium, CISIDAT, Mexico; President, Health Research Consortium, CISIDAT, Mexico
| | | | | | - Janis Serrano-Ortega
- Medical Student, Faculty of Medicine, Universidad Nacional Autónoma de Mexico, Mexico
| | - Diana Vilar-Compte
- Department of Infectious Diseases, Instituto Nacional de Cancerologia, Mexico.
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3
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Maltezou HC, Ledda C, Sipsas NV. Absenteeism of Healthcare Personnel in the COVID-19 Era: A Systematic Review of the Literature and Implications for the Post-Pandemic Seasons. Healthcare (Basel) 2023; 11:2950. [PMID: 37998442 PMCID: PMC10671277 DOI: 10.3390/healthcare11222950] [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: 08/25/2023] [Revised: 11/08/2023] [Accepted: 11/10/2023] [Indexed: 11/25/2023] Open
Abstract
This systematic review aimed to assess COVID-19-associated absenteeism among healthcare personnel (HCP). PubMed was searched on 4 February 2023. Inclusion criteria were the presentation of original data on COVID-19-associated absenteeism among HCP. Exclusion criteria were absenteeism associated with burnout, mental health illness, post-COVID syndrome, or child-care. Nineteen articles were identified; fifteen concerned almost exclusively the first pandemic year. Hospitals accounted for most data. There was heterogeneity across studies in terms of presentation of absenteeism data. Before COVID-19 vaccines became available, COVID-19 was a major driver of HCP absenteeism with excess costs, while the mean duration of absenteeism ranged from 5.82 to 33 days per episode of absence. Determinant factors of absenteeism rates were department of employment, high-risk exposure, age, profession, and work experience of HCP, suspected COVID-19, SARS-CoV-2 testing, SARS-CoV-2 positivity, and return-to-work strategy. Two studies demonstrated that COVID-19 vaccination significantly reduced the burden of absenteeism. Routine testing of asymptomatic HCP and use of personal protective equipment also significantly ameliorated absenteeism. In conclusion, COVID-19 has been a major driver of HCP absenteeism. Research is needed to assess how COVID-19 will impact HCP in the next years, considering the new SARS-CoV-2 variants, the co-circulation of other respiratory viruses, and the newer COVID-19 vaccines. Networks are needed to survey morbidity and absenteeism among HCP in real-time and guide vaccination policies.
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Affiliation(s)
- Helena C. Maltezou
- Directorate of Research, Studies and Documentation, National Public Health Organization, 3-5 Agrafon Street, Marousi, 15123 Athens, Greece
| | - Caterina Ledda
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, 87 Santa Sofia Street, 95124 Catania, Italy;
| | - Nikolaos V. Sipsas
- Pathophysiology Department, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Street, Goudi, 11527 Athens, Greece;
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Blanchet Zumofen MH, Frimpter J, Hansen SA. Impact of Influenza and Influenza-Like Illness on Work Productivity Outcomes: A Systematic Literature Review. PHARMACOECONOMICS 2023; 41:253-273. [PMID: 36515814 PMCID: PMC9748403 DOI: 10.1007/s40273-022-01224-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/10/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Influenza is a persistent public health problem with a significant burden on patients, employers, and society. A systematic review by Keech and Beardsworth (2008) characterized the burden of influenza/influenza-like illness (ILI) on absenteeism. We conducted a systematic literature review evaluating the impact of influenza/ILI on work productivity among adults as an update to the work of Keech and Beardsworth. METHODS This systematic review identified studies evaluating the impact of influenza/ILI on absenteeism, presenteeism, or related work productivity measures for employees and employed caregivers based on laboratory confirmation, physician diagnosis, and/or self-reported illness. Eligible studies were in English, French, or German published from 7 March 2007 through 15 February 2022, in PubMed, Embase, or BIOSIS. Two reviewers completed screening and full-text review, with conflicts resolved by a third advisor. Summary data were extracted by two analysts; all records were quality checked by one analyst. Work productivity outcomes were summarized qualitatively, and risk of bias was not evaluated. RESULTS A total of 14,387 records were retrieved; 12,245 titles/abstracts were screened and 145 full-text publications were reviewed, of which 63 were included in the qualitative assessment. Studies of self-reported ILI were most frequent (49%), followed by laboratory-confirmed cases (37%) and physician diagnoses (11%). Overall, approximately 20-75% of employees missed work due to illness across study settings and populations. Mean time out of work among ill employees varied widely across study designs and populations, ranging from < 1 to > 10 days, and was often reported to be approximately 2-3 days. Considerable heterogeneity was observed across study designs, populations, and outcomes. Most employees (≈ 60-80%) reported working while experiencing influenza/ILI symptoms. Reporting of costs was sparse and heterogeneous; one study reported annual costs of influenza-related absences equating to $42,851 per 100,000 employee health plan members. Results were partitioned based on the following categories. Among otherwise healthy adults, 1-74% of workers missed ≥1 workday due to influenza/ILI, for a mean [standard deviation (SD)] of 0.5 (1.44) to 5.3 (4.50) days, and 42-89% reported working while ill, for a mean (SD) of 0.3 (0.63) to 4.4 (3.73) days. Among working caregivers, 50-75% missed work to care for children/household members with influenza/ILI, for 1-2 days on average. Similarly, the mean absenteeism among healthcare workers ranged from 0.5 to 3.2 days. Across studies evaluating vaccination status, generally smaller proportions of vaccinated employees missed time from work due to influenza/ILI. CONCLUSIONS This systematic review summarized the productivity burden of influenza/ILI on the worldwide working-age population. Despite notable heterogeneity in study designs, influenza/ILI case definitions, and productivity outcome measures, this review highlighted the substantial productivity burden that influenza/ILI may have on employees, employers, and society, consistent with the findings of Keech and Beardsworth (2008).
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Sukhee E, Sovd T, Khaltar U, Hamajima N, Sereenen E, Davaakhuu N, Yamamoto E. Sickness absence among employees of healthcare organizations in the public sector in Mongolia: A cross-sectional study. J Occup Health 2023; 65:e12390. [PMID: 36855219 PMCID: PMC9975147 DOI: 10.1002/1348-9585.12390] [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: 09/16/2022] [Revised: 01/25/2023] [Accepted: 01/27/2023] [Indexed: 03/02/2023] Open
Abstract
OBJECTIVES This study aimed to understand the rate of sickness absence (SA) among employees of public healthcare organizations in Mongolia, to identify factors associated with long-term SA, and to estimate costs due to SA. METHODS This cross-sectional study included employees of public healthcare organizations who had certified SA from 2016 to 2018. Sociodemographic and occupational characteristics of absentees and the data on absences were collected. A logistic regression analysis was performed to identify factors associated with long-term SA (≥15 days) among employees who had SA. Absence parameters and the average costs due to SA were calculated and the total cost due to SA at all public healthcare organizations was estimated. RESULTS From 2016 to 2018, there were 13 653 absentees and 21 043 SA, and the absence rate was 0.9%. The average absence length per absence and absentee were 9.63 days and 14.85 days, respectively. Factors associated with long-term SA were age ≥40 years, 10-19 years in employment, working at the second and tertiary levels, and night shift. The average cost per absentee was 295.5 USD, and the estimated total cost for all health organizations was 1 796 993 USD per year. CONCLUSIONS The absence rate was 0.9% and older age, longer work experience, higher organizational level, and night shift were associated with taking a long-term SA. To reduce the costs of absenteeism and promote the health of employees in healthcare organizations, policymakers should review the policies related to SA and develop national guidelines on SA for employers, healthcare managers, and employees.
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Affiliation(s)
- Erdenetuya Sukhee
- Department of Healthcare AdministrationNagoya University Graduate School of MedicineNagoyaJapan
- Department of Public Administration and ManagementMinistry of HealthUlaanbaatarMongolia
| | - Tugsdelger Sovd
- Department of Monitoring and Evaluation and Internal AuditMinistry of HealthUlaanbaatarMongolia
| | - Ulzii‐Orshikh Khaltar
- Department of Monitoring and Evaluation and Internal AuditMinistry of HealthUlaanbaatarMongolia
| | - Nobuyuki Hamajima
- Department of Healthcare AdministrationNagoya University Graduate School of MedicineNagoyaJapan
| | - Enkhbold Sereenen
- The Digital Development and Marketing DepartmentMongolian National University of Medical SciencesUlaanbaatarMongolia
| | | | - Eiko Yamamoto
- Department of Healthcare AdministrationNagoya University Graduate School of MedicineNagoyaJapan
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6
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Breathnach AS. Rapid covid-19 vaccination for health workers. BMJ 2022; 378:o1674. [PMID: 35858681 DOI: 10.1136/bmj.o1674] [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] [Indexed: 11/03/2022]
Affiliation(s)
- Aodhán S Breathnach
- Infection Care Group, St George's University Hospitals NHS Foundation Trust, London, UK
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7
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Yusoff HM, Sobri HNM, Sundaram V. Factors Influencing Intention to Work while Ill: A Systematic Review. Am J Health Behav 2021; 45:1016-1030. [PMID: 34969413 DOI: 10.5993/ajhb.45.6.6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES The aim of this systematic review was to identify factors influencing workers' intention to work while ill, using the Theory of Planned Behavior (TPB) as a theoretical framework. METHODS A systematic search of articles was carried out from PubMed, Scopus, and Web of Science databases. Eligibility of each article was assessed using PRISMA guidelines. Overall, 22 articles met the inclusion criteria after the selection process and were included in this review. RESULTS The factors fit into 3 constructs: (1) attitude (good and bad consequences of working while ill), (2) subjective norms (descriptive and injunctive norms on working while ill), and (3) perceived behavioral control (facilitators and barriers of working while ill). CONCLUSIONS The TPB is a practical theory to conceptualize and understand the factors influencing workers' intention to work while ill. These findings provide initial knowledge on the development of a framework to measure workers' intention to work while ill and to propose appropriate interventions for workers with chronic illness.
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Affiliation(s)
- Hanizah Mohd Yusoff
- Hanizah Mohd Yusoff, Department of Community Health, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia;,
| | - Hanani Nabilah Mohd Sobri
- Hanani Nabilah Mohd Sobri, Department of Community Health, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Vevya Sundaram
- Vevya Sundaram, Department of Community Health, Universiti Kebangsaan Malaysia, Kuala Lumpur
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8
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Abstract
Health care-acquired viral respiratory infections are common and cause increased patient morbidity and mortality. Although the threat of viral respiratory infection has been underscored by the coronavirus disease 2019 (COVID-19) pandemic, respiratory viruses have a significant impact in health care settings even under normal circumstances. Studies report decreased nosocomial transmission when aggressive infection control measures are implemented, with more success noted when using a multicomponent approach. Influenza vaccination of health care personnel furthers decrease rates of transmission; thus, mandatory vaccination is becoming more common. This article discusses the epidemiology, transmission, and control of health care-associated respiratory viral infections.
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Affiliation(s)
- Joshua G Petrie
- Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, USA
| | - Thomas R Talbot
- Division of Infectious Diseases, Department of Medicine, Vanderbilt University School of Medicine, 1161 21st Avenue South, A-2200 MCN, Nashville, TN 37232, USA.
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9
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Daniels S, Wei H, Han Y, Catt H, Denning DW, Hall I, Regan M, Verma A, Whitfield CA, van Tongeren M. Risk factors associated with respiratory infectious disease-related presenteeism: a rapid review. BMC Public Health 2021; 21:1955. [PMID: 34711208 PMCID: PMC8552205 DOI: 10.1186/s12889-021-12008-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 08/29/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Workplace transmission is a significant contributor to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreaks. Previous studies have found that infectious illness presenteeism could contribute to outbreaks in occupational settings and identified multiple occupational and organisational risk factors. Amid the COVID-19 pandemic, it is imperative to investigate presenteeism particularly in relation to respiratory infectious disease (RID). Hence, this rapid review aims to determine the prevalence of RID-related presenteeism, including COVID-19, and examines the reported reasons and associated risk factors. METHODS The review followed a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) search approach and focused on studies published in English and Chinese. Database searches included MEDLINE, EMBASE, Web of Science, China Knowledge Resource Integrated Database (CNKI) and preprint databases MedRxiv and BioRxiv. RESULTS The search yielded 54 studies, of which four investigated COVID-19-related presenteeism. Prevalence of work presenteeism ranged from 14.1 to 55% for confirmed RID, and 6.6 to 100% for those working with suspected or subclinical RID. The included studies demonstrated that RID-related presenteeism is associated with occupation, sick pay policy, age, gender, health behaviour and perception, vaccination, peer pressure and organisational factors such as presenteeism culture. CONCLUSIONS This review demonstrates that presenteeism or non-adherence to isolation guidance is a real concern and can contribute to workplace transmissions and outbreaks. Policies which would support workers financially and improve productivity, should include a range of effective non-pharmaceutical inventions such as workplace testing, promoting occupational health services, reviewing pay and bonus schemes and clear messaging to encourage workers to stay at home when ill. Future research should focus on the more vulnerable and precarious occupational groups, and their inter-relationships, to develop comprehensive intervention programs to reduce RID-related presenteeism.
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Affiliation(s)
- Sarah Daniels
- Division of Population Health, Health Services Research & Primary Care, School of Health Sciences, The University of Manchester, Ellen Wilkinson Building, Oxford Road, Manchester, M13 9PL, England.
- Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, England.
| | - Hua Wei
- Division of Population Health, Health Services Research & Primary Care, School of Health Sciences, The University of Manchester, Ellen Wilkinson Building, Oxford Road, Manchester, M13 9PL, England
- Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, England
| | - Yang Han
- Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, England
- Department of Mathematics, The University of Manchester, Manchester, England
| | - Heather Catt
- Division of Population Health, Health Services Research & Primary Care, School of Health Sciences, The University of Manchester, Ellen Wilkinson Building, Oxford Road, Manchester, M13 9PL, England
- Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, England
| | - David W Denning
- Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, England
- Division of Evolution, Infection and Genomics, School of Biological Sciences, The University of Manchester, Manchester, England
| | - Ian Hall
- Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, England
- Department of Mathematics, The University of Manchester, Manchester, England
- Public Health, Advice, Guidance and Expertise, London, England
| | - Martyn Regan
- Division of Population Health, Health Services Research & Primary Care, School of Health Sciences, The University of Manchester, Ellen Wilkinson Building, Oxford Road, Manchester, M13 9PL, England
- Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, England
- United Kingdom Health Security Agency National COVID-19 Response Centre, London, England
| | - Arpana Verma
- Division of Population Health, Health Services Research & Primary Care, School of Health Sciences, The University of Manchester, Ellen Wilkinson Building, Oxford Road, Manchester, M13 9PL, England
- Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, England
| | - Carl A Whitfield
- Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, England
- Department of Mathematics, The University of Manchester, Manchester, England
| | - Martie van Tongeren
- Division of Population Health, Health Services Research & Primary Care, School of Health Sciences, The University of Manchester, Ellen Wilkinson Building, Oxford Road, Manchester, M13 9PL, England
- Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, England
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10
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Pereira F, Querido AI, Bieri M, Verloo H, Laranjeira CA. Presenteeism Among Nurses in Switzerland and Portugal and Its Impact on Patient Safety and Quality of Care: Protocol for a Qualitative Study. JMIR Res Protoc 2021; 10:e27963. [PMID: 33983134 PMCID: PMC8160804 DOI: 10.2196/27963] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/12/2021] [Accepted: 04/13/2021] [Indexed: 01/30/2023] Open
Abstract
Background Nurses dispense direct care in a wide variety of settings and are considered the backbone of the health care system. They often work long hours, face emotional stress, and are at a high risk of psychosocial and somatic illnesses. Nurses sometimes fall sick but work regardless, leading to presenteeism and subsequent risks to quality of care and patient safety due to the increased likelihood of patients falling, medication errors, and staff-to-patient disease transmission. Objective This study aims to understand presenteeism among frontline nurses and nurse managers in acute, primary, and long-term health care settings and to contribute to the development of future interventional studies and recommendations. Methods A qualitative study based on online focus group discussions will explore the perceptions of, attitudes to, and experiences with presenteeism among frontline nurses and nurse managers. Using a pilot-tested interview guide, 8 focus group discussions will involve nurses working in acute care hospitals, primary care settings, and long-term residential care facilities in Switzerland’s French-speaking region and Portugal’s Center region. The data collected will be examined using a content analysis approach via NVivo 12 QSR International software. Results The University of Applied Sciences and Arts Western Switzerland’s School of Health Sciences and the Polytechnic of Leiria’s School of Health Sciences in Portugal have both approved funding for the study. The research protocol has been approved by ethics committees in both countries. Study recruitment commenced in February 2021. The results of the data analysis are expected by September 2021. Conclusions This present study aims to gain more insight into the dilemmas facing nurses as a result of all causes of presenteeism among frontline nurses and nurse managers in different health care settings. The researchers will prepare manuscripts on the study’s findings, publish them in relevant peer-reviewed journals, exhibit them in poster presentations, and give oral presentations at appropriate academic and nonscientific conferences. Regarding further knowledge transfer, researchers will engage with stakeholders to craft messages focused on the needs of nurses and nurse managers and on disseminating our research findings to deal with the issue of nursing presenteeism. International Registered Report Identifier (IRRID) PRR1-10.2196/27963
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Affiliation(s)
- Filipa Pereira
- School of Health Sciences, HES-SO Valais/Wallis, Sion, Switzerland.,Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
| | - Ana Isabel Querido
- School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal.,ciTechCare - Center for Innovative Care and Health Technology, Leiria, Portugal.,CINTESIS - Center for Health Technology and Services Research, Leiria, Portugal
| | - Marion Bieri
- School of Health Sciences, HES-SO Valais/Wallis, Sion, Switzerland
| | - Henk Verloo
- School of Health Sciences, HES-SO Valais/Wallis, Sion, Switzerland.,Department of Nursing Sciences, Valais Hospital, Sion, Switzerland.,Service of Old Age Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Carlos António Laranjeira
- School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal.,ciTechCare - Center for Innovative Care and Health Technology, Leiria, Portugal.,Research in Education and Community Intervention, Viseu, Portugal
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11
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Abstract
Influenza infection poses significant risk for solid organ transplant recipients who often experience more severe infection with increased rates of complications, including those relating to the allograft. Although symptoms of influenza experienced by transplant recipients are similar to that of the general population, fever is not a ubiquitous symptom and lymphopenia is common. Annual inactivated influenza vaccine is recommended for all transplant recipients. Newer strategies such as using a higher dose vaccine or multiple doses in the same season appear to provide greater immunogenicity. Neuraminidase inhibitors are the mainstay of treatment and chemoprophylaxis although resistance may occur in the transplant setting. Influenza therapeutics are advancing, including the recent licensure of baloxavir; however, many remain to be evaluated in transplant recipients and are not yet in routine clinical use. Further population-based studies spanning multiple influenza seasons are needed to enhance our understanding of influenza epidemiology in solid organ transplant recipients. Specific assessment of newer influenza therapeutics in transplant recipients and refinement of prevention strategies are vital to reducing morbidity and mortality.
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Affiliation(s)
- Tina M Marinelli
- Division of Infectious Diseases, Multi-Organ Transplant Program, University Health Network, Toronto, ON, Canada
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12
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Barriers and facilitators to influenza-like illness absenteeism among healthcare workers in a tertiary-care healthcare system, 2017-2018 influenza season. Infect Control Hosp Epidemiol 2021; 42:1198-1205. [PMID: 33650477 DOI: 10.1017/ice.2020.1396] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Influenza can be introduced and propagated in healthcare settings by healthcare workers (HCWs) working while ill with influenza. However, reasons driving this behavior are unclear. In this study, we examined barriers to and facilitators of absenteeism during the influenza season. DESIGN Cross-sectional mixed methods study. SETTING Ambulatory and inpatient settings in a large, tertiary-care healthcare system. METHODS An anonymous electronic survey was sent to HCWs between June 11 and July 13, 2018, asking participants to self-report influenza-like illness (ie, ILI symptoms of fever, chills, cough, or sore throat) during the 2017-2018 influenza season. We conducted a logistical regression analysis to identify factors associated with absenteeism. RESULTS Of 14,250 HCWs, 17% responded to the survey. Although 1,180 respondents (51%) reported symptoms of ILI, 575 (43%) did not stay home while ill. The most commonly perceived barriers to ILI absenteeism included being understaffed (odds ratio [OR], 1.78; P = .04), unable to find a replacement for work (OR, 2.26; P = .03), desiring not to use time off (OR, 2.25; P = .003), and paid by the hour or unable to afford being absent (OR, 2.05; P = .02). Common perceived facilitators of absenteeism included support from coworkers and management, clearer policy, better sick days availability, and lower perceived threat of disciplinary action. CONCLUSIONS Reporting to work with ILI symptoms is common among HCWs. Most barriers and facilitators are related to systems. Addressing system factors, such as policies regarding sick days and sick leave and ensuring adequate backup staffing, is likely to facilitate absenteeism among ill HCWs.
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AL‐Abrrow H, Al‐Maatoq M, Alharbi RK, Alnoor A, Abdullah HO, Abbas S, Khattak ZZ. Understanding employees’ responses to the
COVID
‐19 pandemic: The attractiveness of healthcare jobs. GLOBAL BUSINESS AND ORGANIZATIONAL EXCELLENCE 2020. [PMCID: PMC7753666 DOI: 10.1002/joe.22070] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The purpose of this study was to examine the impact of COVID‐19 on the attractiveness of work in the Iraqi health sector by looking at the mediating role of employees' attitudes. A questionnaire survey was used to collect data from 218 health sector employees. The results revealed that there is a significant impact of COVID‐19 pandemic on employees' attitudes that influence their decision to quit the health sector and look for jobs in other sectors. As health sector employees are prone to suffer the most in the pandemic, this crisis significantly affected the attractiveness of jobs in the health sector, leading to an increase in employees' negative attitudes and their desire to leave work.
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14
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Absenteeism and presenteeism in healthcare workers due to respiratory illness. Infect Control Hosp Epidemiol 2020; 42:268-273. [PMID: 33239124 DOI: 10.1017/ice.2020.444] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To assess influenza symptoms, adherence to mask use recommendations, absenteesm and presenteeism in acute care healthcare workers (HCWs) during influenza epidemics. METHODS The TransFLUas influenza transmission study in acute healthcare prospectively followed HCWs prospectively over 2 consecutive influenza seasons. Symptom diaries asking for respiratory symptoms and adherence with mask use recommendations were recorded on a daily basis, and study participants provided midturbinate nasal swabs for influenza testing. RESULTS In total, 152 HCWs (65.8% nurses and 13.2% physicians) were included: 89.1% of study participants reported at least 1 influenza symptom during their study season and 77.8% suffered from respiratory symptoms. Also, 28.3% of HCW missed at least 1 working day during the study period: 82.6% of these days were missed because of symptoms of influenza illness. Of all participating HCWs, 67.9% worked with symptoms of influenza infection on 8.8% of study days. On 0.3% of study days, symptomatic HCWs were shedding influenza virus while at work. Among HCWs with respiratory symptoms, 74.1% adhered to the policy to wear a mask at work on 59.1% of days with respiratory symptoms. CONCLUSIONS Respiratory disease is frequent among HCWs and imposes a significant economic burden on hospitals due to the number of working days lost. Presenteesm with respiratory illness, including influenza, is also frequent and poses a risk for patients and staff. TRIAL REGISTRATION NCT02478905 (clinicaltrials.gov).
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15
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Beyond personal protective equipment: adjunctive methods for control of healthcare-associated respiratory viral infections. Curr Opin Infect Dis 2020; 33:312-318. [PMID: 32657968 DOI: 10.1097/qco.0000000000000655] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE OF REVIEW Prevention of nosocomial transmission of respiratory viruses is a priority in all healthcare settings and often achieved with the use of personal protective equipment. Several adjunctive infection prevention methods are in common use but their effectiveness in reducing healthcare-associated respiratory viral infections is unclear. In this review, recent advances regarding the effectiveness of several adjunctive infection prevention methods to reduce healthcare-associated respiratory viral infections are discussed. RECENT FINDINGS Training and education on hand hygiene guidelines, mandatory influenza vaccination for healthcare personnel, access to paid sick leave to reduce ill presenteeism, cohorting of patients with the same infection or clinical syndrome, neuraminidase inhibitor chemoprophylaxis during influenza outbreaks, and enhanced visitor restrictions in pediatric hospitals all have shown some degree of effectiveness in observational or quasi-experimental studies. SUMMARY Most of the studies evaluating the effect of adjunctive infection prevention methods on healthcare-associated respiratory viral infections are observational or quasi-experimental and are often combined with other interventions. Therefore, it is difficult to determine the precise effectiveness or efficacy of these interventions and more controlled trials are needed. Multimodal infection prevention policies are likely to be most effective in reducing healthcare-associated respiratory viral infections.
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16
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Peytremann A, Senn N, Mueller Y. Are healthcare workers more likely than the general population to consult in primary care for an influenza-like illness? Results from a case-control study. Influenza Other Respir Viruses 2020; 14:524-529. [PMID: 32374511 PMCID: PMC7431651 DOI: 10.1111/irv.12750] [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] [Received: 02/24/2020] [Revised: 04/14/2020] [Accepted: 04/16/2020] [Indexed: 11/29/2022] Open
Abstract
Background Healthcare workers are at increased risk of contracting influenza. However, existing studies do not differentiate professional categories or domains of the healthcare system that are most at risk. Methods This case‐control study compared proportions of patients with professional activity in the healthcare system between cases consulting their primary care physician for an influenza‐like illness (ILI) and controls from the general patient population of the same practices of the Swiss sentinel network. Influenza was confirmed by rRT‐PCR in a subset of practices. Analysis used a mixed logistic regression model, including age and sex as potential confounders. Results During the 2018/2019 influenza surveillance season, out of 4287 ILI cases and 28 561 controls reported in 168 practices, 235 (5.5%), respectively 872 (3.1%), were active in the healthcare system. After adjustment, being active in health care increased the odds of consulting for an ILI (OR 1.66, 95% CI 1.40‐1.97). The association was strongest for physicians and nursing aides. In terms of work setting, odds of consulting for ILI were increased for professionals of almost all healthcare settings except home‐based care. Conclusion Individuals active in the healthcare system were more likely to consult their primary care physician for an influenza‐like illness than for another reason, compared with individuals not active in the healthcare system. These results warrant further efforts to understand influenza transmission in the healthcare system at large.
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Affiliation(s)
- Arnaud Peytremann
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Nicolas Senn
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Yolanda Mueller
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
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17
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Buckrell S, Coleman BL, McNeil SA, Katz K, Muller MP, Simor A, Loeb M, Powis J, Kuster SP, Di Bella JM, Coleman KKL, Drews SJ, Kohler P, McGeer A. Sources of viral respiratory infections in Canadian acute care hospital healthcare personnel. J Hosp Infect 2020; 104:513-521. [PMID: 31954763 PMCID: PMC7172118 DOI: 10.1016/j.jhin.2020.01.009] [Citation(s) in RCA: 4] [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] [Received: 11/18/2019] [Accepted: 01/09/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Viral respiratory illnesses are common causes of outbreaks and can be fatal to some patients. AIM To investigate the association between laboratory-confirmed viral respiratory infections and potential sources of exposure during the previous 7 days. METHODS In this nested case-control analysis, healthcare personnel from nine Canadian hospitals who developed acute respiratory illnesses during the winters of 2010/11-2013/14 submitted swabs that were tested for viral pathogens. Associated illness diaries and the weekly diaries of non-ill participants provided information on contact with people displaying symptoms of acute respiratory illness in the previous week. Conditional logistic regression assessed the association between cases, who were matched by study week and site with controls with no respiratory symptoms. FINDINGS There were 814 laboratory-confirmed viral respiratory illnesses. The adjusted odds ratio (aOR) of a viral illness was higher for healthcare personnel reporting exposures to ill household members [7.0, 95% confidence interval (CI) 5.4-9.1], co-workers (3.4, 95% CI 2.4-4.7) or other social contacts (5.1, 95% CI 3.6-7.1). Exposures to patients with respiratory illness were not associated with infection (aOR 0.9, 95% CI 0.7-1.2); however, healthcare personnel with direct patient contact did have higher odds (aOR 1.3, 95% CI 1.1-1.6). The aORs for exposure and for direct patient contact were similar for illnesses caused by influenza. CONCLUSION Community and co-worker contacts are important sources of viral respiratory illness in healthcare personnel, while exposure to patients with recognized respiratory infections is not associated. The comparatively low risk associated with direct patient contact may reflect transmission related to asymptomatic patients or unrecognized infections.
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Affiliation(s)
- S Buckrell
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - B L Coleman
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Sinai Health System, Toronto, ON, Canada.
| | - S A McNeil
- Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and Nova Scotia Health Authority, Halifax, NS, Canada
| | - K Katz
- North York General Hospital and Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - M P Muller
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada; Unity Health, Toronto, ON, Canada
| | - A Simor
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - M Loeb
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
| | - J Powis
- Toronto East Health Network, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - S P Kuster
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital and University of Zurich, Zürich, Switzerland
| | | | - K K L Coleman
- Sinai Health System, Toronto, ON, Canada; Parkwood Institute, London Health Sciences Centre, London, ON, Canada
| | - S J Drews
- Canadian Blood Services, Edmonton, AB, Canada; Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada
| | - P Kohler
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital, St. Gallen, Switzerland
| | - A McGeer
- Sinai Health System, Toronto, ON, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
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18
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Are healthcare personnel at higher risk of seasonal influenza than other working adults? Infect Control Hosp Epidemiol 2020. [DOI: 10.1017/ice.2019.334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractBackground: Adults are at risk of being exposed to influenza from many sources. Healthcare personnel (HCP) have the additional risk of being exposed to ill patients.Objective:To determine whether HCP were at higher risk than adults working in nonhealthcare roles (non-HCP).Design:Prospective cohort study.Setting:Acute-care hospitals and other businesses in Toronto, Ontario, Canada.Methods:Adults aged 18–69 years were enrolled for 1 or more of the 2010/2011, 2011/2012, and 2012/2013 influenza seasons. Swabs collected during acute respiratory illnesses were tested for influenza and pre- and postseason blood samples were tested for influenza-specific immune response.Results:The adjusted odds of influenza were similar for HCP and non-HCP (odds ratio [OR], 1.29; 95% confidence interval [CI], 0.63–2.63). Older adults and those vaccinated against influenza had lower odds, and those who shared their workspace and who used corrective eyewear had higher odds of influenza.Conclusions:HCP and other working adults are at similar risk of influenza infection.
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19
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Age: A variable whose definition we should not ignore. Infect Control Hosp Epidemiol 2019; 40:1444-1445. [PMID: 31589135 DOI: 10.1017/ice.2019.271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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20
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The effect of timing on community acquired respiratory virus infection mortality during the first year after allogeneic hematopoietic stem cell transplantation: a prospective epidemiological survey. Bone Marrow Transplant 2019; 55:431-440. [PMID: 31551521 PMCID: PMC7091566 DOI: 10.1038/s41409-019-0698-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 07/10/2019] [Accepted: 07/27/2019] [Indexed: 11/08/2022]
Abstract
The effect of timing of community acquired respiratory virus (CARV) infection after allogeneic hematopoietic stem cell transplant (allo-HCT) is an as yet unsettled issue. We evaluate this issue by including all consecutive allo-HCT recipients with molecularly-documented CARV infection during the first year after transplant. The study cohort was drawn from a prospective longitudinal survey of CARV in allo-HCT recipient having respiratory symptoms conducted from December 2013 to December 2018 at two Spanish transplant centers. Respiratory viruses in upper and/or lower respiratory specimens were tested using multiplex PCR panel assays. The study cohort comprised 233 allo-HCT recipients with 376 CARV infection episodes diagnosed during the first year after allo-HCT. Overall, 60% of CARV episodes occurred within the first 6 months (227 out of 376). Thirty patients (13%) had died at 3 months after CARV detection, of which 25 (83%) were recipients developing CARV within the first 6 months after transplant. Multivariate analysis identified four risk factors for mortality: ATG used as part of conditioning regimen [odds ratio (OR) 2.8, 95% confidence interval (C.I.) 1.21-6.4, p = 0.01], CARV lower respiratory tract disease (OR 3.4, 95% C.I. 1.4-8.4, p = 0.007), CARV infection within the first 6 months of transplant (OR 3.04, 95% C.I. 1.1-8.7, p = 0.03), and absolute lymphocyte count <0.2 × 109/L (OR 2.4, 95% C.I. 1-5.3, p = 0.04). Developing CARV infection within the first 6 months was associated with higher mortality. Our data supports that the timing of CARV development after allo-HCT could be of major interest.
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