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Di Tosto G, Melnyk H, Powell JR, Kenah E, Gage CB, Panchal AR, McAlearney AS. COVID-19 and coworker conflict among emergency medical service clinicians. J Am Coll Emerg Physicians Open 2024; 5:e13282. [PMID: 39224420 PMCID: PMC11367663 DOI: 10.1002/emp2.13282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Revised: 07/23/2024] [Accepted: 07/29/2024] [Indexed: 09/04/2024] Open
Abstract
Objectives Safety policies enacted in response to the emergence of coronavirus disease 2019 (COVID-19) have greatly affected the working environments of emergency medical service (EMS) clinicians. Our objective was to evaluate whether changes in the EMS environment during the COVID-19 pandemic were associated with increased workplace conflict. Methods This evaluation was a cross-sectional analysis of a random sample of 19,497 national certified EMS clinicians who were selected to receive an electronic survey in April 2022. The survey included an assessment of their level of stress using the Perceived Stress Scale instrument and examined changes in their working environment they perceived had occurred due to the emergence of COVID-19. Logistic regression modeling was used to evaluate the associations between workforce demographics, infrastructure, scheduling, and policies to and COVID-19-induced coworker conflict. Results A total of 1686 responses were evaluated (response rate 10%). We found that COVID-19 was reported to have exacerbated conflict between coworkers in 51% of responses. Respondents who perceived an increase in coworker conflict due to COVID-19 self-reported higher levels of stress than the rest of the respondents. Perceptions of the impact of COVID-19 on conflict had also an association with the level of certification, indicating that national registered paramedics were more likely than emergency medical technicians to report coworker conflict due to COVID-19 (adjusted odds ratio [AOR] 1.30, 95% confidence interval [CI] 1.05-1.61). Multivariable analysis highlighted the impact of mandatory overtime policies, reported by 27% of the respondents and associated with higher odds of exacerbated coworker conflict in our model (AOR 2.05, 95% CI 1.62-2.60). Conclusions These findings indicate that conflict can be considered a potential indicator of high levels of stress in the EMS workforce and may be a reliable signal to monitor when implementing mandates that affect EMS clinicians and their workloads.
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Affiliation(s)
- Gennaro Di Tosto
- The Center for the Advancement of Team Science, Analyticsand Systems Thinking in Health Services and Implementation Science Research (CATALYST)The Ohio State University College of MedicineColumbusOhioUSA
| | - Halia Melnyk
- The Center for the Advancement of Team Science, Analyticsand Systems Thinking in Health Services and Implementation Science Research (CATALYST)The Ohio State University College of MedicineColumbusOhioUSA
| | - Jonathan R. Powell
- National Registry of Emergency Medical TechniciansColumbusOhioUSA
- Division of EpidemiologyThe Ohio State University College of Public HealthColumbusOhioUSA
| | - Eben Kenah
- Division of BiostatisticsThe Ohio State University College of Public HealthColumbusOhioUSA
| | - Christopher B. Gage
- National Registry of Emergency Medical TechniciansColumbusOhioUSA
- Division of EpidemiologyThe Ohio State University College of Public HealthColumbusOhioUSA
| | - Ashish R. Panchal
- National Registry of Emergency Medical TechniciansColumbusOhioUSA
- Division of EpidemiologyThe Ohio State University College of Public HealthColumbusOhioUSA
- Department of Emergency MedicineThe Ohio State University Wexner Medical CenterColumbusOhioUSA
| | - Ann Scheck McAlearney
- The Center for the Advancement of Team Science, Analyticsand Systems Thinking in Health Services and Implementation Science Research (CATALYST)The Ohio State University College of MedicineColumbusOhioUSA
- Department of Family and Community MedicineThe Ohio State University College of MedicineColumbusOhioUSA
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Myrskykari H, Nordquist H. Paramedics' experiences and observations: work-related emotions and well-being resources during the initial months of the COVID-19 pandemic-a qualitative study. BMC Emerg Med 2024; 24:152. [PMID: 39183333 PMCID: PMC11346295 DOI: 10.1186/s12873-024-01072-0] [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: 04/25/2024] [Accepted: 08/13/2024] [Indexed: 08/27/2024] Open
Abstract
BACKGROUND As first responders, paramedics are an extremely important part of the care chain. COVID-19 significantly impacted their working circumstances. We examined, according to the experiences and observations of paramedics, (1) what kinds of emotions the Emergency Medical Service (EMS) personnel experienced in their new working circumstances, and (2) what work-related factors became resources for the well-being of EMS personnel during the initial months of the COVID-19 pandemic. METHODS This qualitative study utilized reflective essay material written by experienced, advanced-level Finnish paramedics (n = 30). The essays used in this study were written during the fall of 2020 and reflected the period when Finland had declared a state of emergency (on 17.3.2020) and the Emergency Powers Act was implemented. The data was analyzed using an inductive thematic analysis. RESULTS The emotions experienced by the EMS personnel in their new working circumstances formed three themes: (1) New concerns arose that were constantly present; (2) Surviving without proper guidance; and (3) Rapidly approaching breaking point. Three themes were formed from work-related factors that were identified as resources for the well-being of the EMS personnel. These were: (1) A high level of organizational efficiency was achieved; (2) Adaptable EMS operations; and (3) Encouraging atmosphere. CONCLUSIONS Crisis management practices should be more attentive to personnel needs, ensuring that managerial and psychological support is readily available in crisis situations. Preparedness that ensures effective organizational adaptation also supports personnel well-being during sudden changes in working circumstances.
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Affiliation(s)
- Henna Myrskykari
- Faculty of Medicine, University of Helsinki, Helsinki, Finland.
- Emergency Medical Services, University of Turku and Turku University Hospital, Turku, Finland.
| | - Hilla Nordquist
- Department of Healthcare and Emergency Care, South-Eastern Finland University of Applied Sciences, Kotka, Finland
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Laparidou D, Curtis F, Wijegoonewardene N, Akanuwe J, Weligamage DD, Koggalage PD, Siriwardena AN. Emergency medical service interventions and experiences during pandemics: A scoping review. PLoS One 2024; 19:e0304672. [PMID: 39088585 PMCID: PMC11293743 DOI: 10.1371/journal.pone.0304672] [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: 07/22/2023] [Accepted: 05/15/2024] [Indexed: 08/03/2024] Open
Abstract
BACKGROUND The global impact of COVID-19 has been profound, with efforts to manage and contain the virus placing increased pressure on healthcare systems and Emergency Medical Services (EMS) in particular. There has been no previous review of studies investigating EMS interventions or experiences during pandemics. The aim of this scoping review was to identify and present published quantitative and qualitative evidence of EMS pandemic interventions, and how this translates into practice. METHODS Six electronic databases were searched from inception to July 2022, supplemented with internet searches and forward and backward citation tracking from included studies and review articles. A narrative synthesis of all eligible quantitative studies was performed and structured around the aims, key findings, as well as intervention type and content, where appropriate. Data from the qualitative studies were also synthesised narratively and presented thematically, according to their main aims and key findings. RESULTS The search strategy identified a total of 22,599 citations and after removing duplicates and excluding citations based on title and abstract, and full text screening, 90 studies were included. The quantitative narrative synthesis included seven overarching themes, describing EMS pandemic preparedness plans and interventions implemented in response to pandemics. The qualitative data synthesis included five themes, detailing the EMS workers' experiences of providing care during pandemics, their needs and their suggestions for best practices moving forward. CONCLUSIONS Despite concerns for their own and their families' safety and the many challenges they are faced with, especially their knowledge, training, lack of appropriate Personal Protective Equipment (PPE) and constant protocol changes, EMS personnel were willing and prepared to report for duty during pandemics. Participants also made recommendations for future outbreak response, which should be taken into consideration in order for EMS to cope with the current pandemic and to better prepare to respond to any future ones. TRIAL REGISTRATION The review protocol was registered with the Open Science Framework (osf.io/2pcy7).
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Affiliation(s)
- Despina Laparidou
- Community and Health Research Unit, School of Health and Social Care, University of Lincoln, Brayford Pool, Lincoln, United Kingdom
| | - Ffion Curtis
- Department of Health Data Science, Liverpool Reviews & Implementation Group (LRiG), Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
| | - Nimali Wijegoonewardene
- Community and Health Research Unit, School of Health and Social Care, University of Lincoln, Brayford Pool, Lincoln, United Kingdom
- Ministry of Health, Colombo, Sri Lanka
| | - Joseph Akanuwe
- Community and Health Research Unit, School of Health and Social Care, University of Lincoln, Brayford Pool, Lincoln, United Kingdom
| | - Dedunu Dias Weligamage
- Community and Health Research Unit, School of Health and Social Care, University of Lincoln, Brayford Pool, Lincoln, United Kingdom
- Ministry of Health, Colombo, Sri Lanka
| | - Prasanna Dinesh Koggalage
- Community and Health Research Unit, School of Health and Social Care, University of Lincoln, Brayford Pool, Lincoln, United Kingdom
- Ministry of Health, Colombo, Sri Lanka
| | - Aloysius Niroshan Siriwardena
- Community and Health Research Unit, School of Health and Social Care, University of Lincoln, Brayford Pool, Lincoln, United Kingdom
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Ferber MF, Chen T, McHowat J, Charney RL, Bitter CC. Perceived and Received Support by Academic Medicine Faculty During the COVID-19 Pandemic: A Single Institution Study. Disaster Med Public Health Prep 2024; 18:e3. [PMID: 38214070 DOI: 10.1017/dmp.2023.240] [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: 01/13/2024]
Abstract
OBJECTIVE The COVID-19 pandemic negatively impacted healthcare worker well-being, leading to increased burnout and decreased workplace engagement. To combat expected stressors from the pandemic, our mid-sized academic health center implemented numerous institutional support, such as town halls, and virtual support groups. This study aimed to evaluate faculty utilization of institutional support, its association with perceived organizational support, received organizational support, and burnout. METHODS A retrospective, cross-sectional survey was distributed to 630 faculty employed at our institution in September 2020, assessing participant demographics, institutional support utilized, perceived organizational support, and burnout, through a combination of self-report measures and qualitative responses. RESULTS A total of 79 (12.5%) faculty provided complete responses and were included in the analysis. Qualitative analysis identified 4 primary themes: (1) flexibility and adjusted expectations, (2) direct communication, (3) sense of community, and (4) no support felt, with additional subthemes within each larger theme. Increased utilization of institutional support was associated with decreased odds of experiencing burnout. CONCLUSION Flexibility, communication, and sense of community emerged as important strategies for maintaining faculty well-being and engagement during the early stages of the COVID-19 pandemic. This study suggests that utilization of workplace support is protective against burnout. Perceived support was not beneficial.
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Affiliation(s)
- Megan Ferriby Ferber
- Medical Family Therapy Program, Department of Family and Community Medicine, Saint Louis University School of Medicine, Saint Louis, Missouri
| | - Tina Chen
- Department of Surgery, Saint Louis University School of Medicine, Saint Louis, Missouri
| | - Jane McHowat
- Department of Pathology, Saint Louis University School of Medicine, St. Louis, MO
| | - Rachel L Charney
- Department of Pediatrics, Saint Louis University School of Medicine, Saint Louis, MO
| | - Cindy C Bitter
- Department of Surgery, Saint Louis University School of Medicine, Saint Louis, Missouri
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Goniewicz K, Sarker MNI, Schoch-Spana M. Reimagining natural hazards and disaster preparedness: charting a new course for the future. BMC Public Health 2023; 23:581. [PMID: 36978174 PMCID: PMC10053712 DOI: 10.1186/s12889-023-15497-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 03/21/2023] [Indexed: 03/30/2023] Open
Affiliation(s)
- Krzysztof Goniewicz
- Department of Security Studies, Polish Air Force University, Deblin, Poland.
| | - Md Nazirul Islam Sarker
- School of Social Sciences, Universiti Sains Malaysia, Pulau Pinang, Malaysia.
- Department of Development Studies, Daffodil International University, Dhaka, Bangladesh.
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Du BB, Rezvani S, Bigelow P, Nowrouzi-Kia B, Boscart VM, Yung M, Yazdani A. Synthesis of Evidence to Support EMS Personnel's Mental Health During Disease Outbreaks: A Scoping Review. Saf Health Work 2022; 13:379-386. [PMID: 36579015 PMCID: PMC9772480 DOI: 10.1016/j.shaw.2022.08.006] [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: 04/12/2022] [Revised: 08/15/2022] [Accepted: 08/17/2022] [Indexed: 12/31/2022] Open
Abstract
Emergency medical services (EMS) personnel are at high risk for adverse mental health outcomes during disease outbreaks. To support the development of evidence-informed mitigation strategies, we conducted a scoping review to identify the extent of research pertaining to EMS personnel's mental health during disease outbreaks and summarized key factors associated with mental health outcomes. We systematically searched three databases for articles containing keywords within three concepts: EMS personnel, disease outbreaks, and mental health. We screened and retained original peer-reviewed articles that discussed, in English, EMS personnel's mental health during disease outbreaks. Where inferential statistics were reported, the associations between individual and work-related factors and mental health outcomes were synthesized. Twenty-five articles were eligible for data extraction. Our findings suggest that many of the contributing factors for adverse mental health outcomes are related to inadequacies in fulfilling EMS personnel's basic safety and informational needs. In preparation for future disease outbreaks, resources should be prioritized toward ensuring adequate provisions of personal protective equipment and infection prevention and control training. This scoping review serves as a launching pad for further research and intervention development.
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Affiliation(s)
- Bronson B. Du
- Canadian Institute for Safety, Wellness, and Performance, School of Business, Conestoga College Institute of Technology and Advanced Learning, Kitchener, ON, Canada,Corresponding author. Canadian Institute for Safety, Wellness, and Performance, School of Business, Conestoga College Institute of Technology and Advanced Learning, Kitchener, ON N2G 4M4, Canada.
| | - Sara Rezvani
- Canadian Institute for Safety, Wellness, and Performance, School of Business, Conestoga College Institute of Technology and Advanced Learning, Kitchener, ON, Canada
| | - Philip Bigelow
- Centre of Research Expertise for the Prevention of Musculoskeletal Disorders, Waterloo, ON, Canada,School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada,Institute for Work & Health, Toronto, ON, Canada
| | - Behdin Nowrouzi-Kia
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Veronique M. Boscart
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada,Canadian Institute for Seniors Care, School of Health and Life Sciences, Conestoga College Institute of Technology and Advanced Learning, Kitchener, ON, Canada
| | - Marcus Yung
- Canadian Institute for Safety, Wellness, and Performance, School of Business, Conestoga College Institute of Technology and Advanced Learning, Kitchener, ON, Canada
| | - Amin Yazdani
- Canadian Institute for Safety, Wellness, and Performance, School of Business, Conestoga College Institute of Technology and Advanced Learning, Kitchener, ON, Canada,Centre of Research Expertise for the Prevention of Musculoskeletal Disorders, Waterloo, ON, Canada,School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada,School of Geography and Earth Sciences, McMaster University, Hamilton, ON, Canada
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7
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Santinha G, Forte T, Gomes A. Willingness to Work during Public Health Emergencies: A Systematic Literature Review. Healthcare (Basel) 2022; 10:1500. [PMID: 36011158 PMCID: PMC9408569 DOI: 10.3390/healthcare10081500] [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: 06/30/2022] [Revised: 07/24/2022] [Accepted: 08/03/2022] [Indexed: 11/16/2022] Open
Abstract
The identification of the factors underlying the willingness or lack thereof to respond to public health emergencies is paramount to informing more capable health services. The interest in this topic appears renewed with each surge of threat, either referring to natural disasters, man-made violence, or epidemic and pandemics. However, there is no systematic approach to the research patterns and related main findings concerning individual and contextual determinants. The present article contributes to this theme through a systematic literature review of a sample of 150 articles published in the last 30 years on the subject of willingness and preparedness of health professionals to deal with public health threats. Our findings show that the research is mainly phenomena and contextual driven, responding to whichever emergency threat is more salient in a given period. Geographically, research on this topic is led by USA and China, mostly solely, while European countries invest in collaborations that are more international. Universities, including health institutes and schools, and researchers at hospitals conduct most of the research on the topic. The main research areas are medicine, psychology, and psychiatry. Pandemics, including COVID-19, influenza, and natural disasters, are the phenomena gauging more attention as opposed to terrorism events and biological accidents. The specific role of health professionals within the institution, their belief in ethical duties, preparation training, and concerns regarding infection of self and family are the main variables influencing the willingness and ability to report to work in public health emergencies.
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Affiliation(s)
- Gonçalo Santinha
- GOVCOPP, Department of Social, Political and Territorial, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Teresa Forte
- Department of Social, Political and Territorial Sciences, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Ariana Gomes
- Department of Social, Political and Territorial Sciences, University of Aveiro, 3810-193 Aveiro, Portugal
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Li L, Gao X, Wang Y, Zeng C, Hou L, Xi Q. Professional identity and supporting willingness of nurses during the
COVID
‐19 epidemic in China. Jpn J Nurs Sci 2022; 19:e12487. [PMID: 35347842 PMCID: PMC9115074 DOI: 10.1111/jjns.12487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 02/23/2022] [Accepted: 03/01/2022] [Indexed: 11/27/2022]
Abstract
Aim To investigate the professional identities and the willingness of nurses to respond to the call for support during the COVID‐19 epidemic. Background The COVID‐19 epidemic has resulted in nearly 300 million cases worldwide, causing more than five million deaths. However, the professional identities and the willingness of nurses to provide support during the COVID‐19 epidemic in China remain unclear. Methods A total of 1,505 eligible nurses from 120 hospitals during the COVID‐19 outbreak in China were included. Questionnaires were used to evaluate the willingness of these nurses to participate in epidemic control efforts. The Nurses' Professional Identity Scale was used to measure their sense of professional identity. Results About 90% of the nurses were willing to lend support in Hubei Province during the epidemic. The most common reason (93.84%) was found to be their beliefs as medical personnel in helping others in need. Nearly 10% of the nurses were unwilling to go to Hubei, primarily due to family reasons. The average total score of the Professional Identity Scale for all nurses reached a moderate to high level as indication of professional identity (116–125). Nurses who were willing to go to Hubei had a significantly higher total score than those who were not. Conclusions The professional identity of nurses in China improved during the epidemic, and those with higher professional identities were more likely to respond to calls for support during the epidemic.
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Affiliation(s)
- Li Li
- Department of Nursing, Shanghai Ninth People's Hospital Shanghai Jiao Tong University School of Medicine Shanghai China
- Department of Nursing, Mental Health Center Shanghai Jiao Tong University School of Medicine Shanghai China
| | - Xiaoyue Gao
- Department of Nursing, Shanghai Ninth People's Hospital Shanghai Jiao Tong University School of Medicine Shanghai China
| | - Yanbo Wang
- Division of Medical Humanities & Behavioral sciences, School of Medicine Tongji University Shanghai China
| | - Changjuan Zeng
- Department of Nursing, Shanghai Ninth People's Hospital Shanghai Jiao Tong University School of Medicine Shanghai China
| | - Lili Hou
- Department of Nursing, Shanghai Ninth People's Hospital Shanghai Jiao Tong University School of Medicine Shanghai China
| | - Qinghong Xi
- Department of Nursing, Shanghai Ninth People's Hospital Shanghai Jiao Tong University School of Medicine Shanghai China
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Muñoz-Rubilar CA, Carrillos CP, Mundal IP, Cuevas CDL, Lara-Cabrera ML. The duty to care and nurses' well-being during a pandemic. Nurs Ethics 2022; 29:527-539. [PMID: 35142227 PMCID: PMC9127934 DOI: 10.1177/09697330211041746] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: The coronavirus disease 2019 pandemic is impacting the delivery of healthcare
worldwide, creating dilemmas related to the duty to care. Although
understanding the ethical dilemmas about the duty to care among nurses is
necessary to allow effective preparation, few studies have explored these
concerns. Aim: This study aimed to identify the ethical dilemmas among clinical nurses in
Spain and Chile. It primarily aimed to (1) identify nurses’ agreement with
the duty to care despite high risks for themselves and/or their families,
(2) describe nurses’ well-being and (3) describe the associations between
well-being and the duty to care. Research design: Cross-sectional self-reported anonymous data were collected between May and
June 2020 via electronic survey distribution (snowball sampling). Ethical considerations: The Institutional Ethical Review Committees in both countries approved the
study (CHUC_2020_33 and 27/2020). Findings: In total, 345 clinical nurses answered the primary question about the duty to
care for the sick. Although in the total sample 77.4% agreed they have a
duty to care for the sick, significant differences were found between the
Spanish and Chilean samples. Overall, 53.6% of the nurses reported low
levels of well-being; however, among those reporting low well-being,
statistically significant differences were found between Spanish and Chilean
nurses as 19.4% and 37.8%, respectively, disagreed with the statement
regarding the duty to care. Discussion: Participants in both countries reported several ethical dilemmas, safety
fears, consequent stress and low well-being. These results suggest that
prompt actions are required to address nurses’ ethical concerns, as they
might affect their willingness to work and psychological well-being. Conclusion: Our findings shed light on the ethical dilemmas nurses are facing related to
the duty to care. Not only has the coronavirus disease 2019 pandemic given
rise to ethical challenges, but it has also affected nurses’ well-being and
willingness to work during a pandemic.
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Affiliation(s)
| | | | | | - Carlos De Las Cuevas
- Department of Internal Medicine, Dermatology and Psychiatry, University of La Laguna, San Cristóbal de La Laguna, Spain and Instituto Universitario de Neurociencias (IUNE), Universidad de La Laguna, Canary Islands, Spain
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Soto-Cámara R, García-Santa-Basilia N, Onrubia-Baticón H, Cárdaba-García RM, Jiménez-Alegre JJ, Reques-Marugán AM, Molina-Oliva M, Fernández-Domínguez JJ, Matellán-Hernández MP, Morales-Sanchez A, Navalpotro-Pascual S. Psychological Impact of the COVID-19 Pandemic on Out-of-Hospital Health Professionals: A Living Systematic Review. J Clin Med 2021; 10:5578. [PMID: 34884280 PMCID: PMC8658089 DOI: 10.3390/jcm10235578] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 11/22/2021] [Accepted: 11/24/2021] [Indexed: 12/23/2022] Open
Abstract
Health professionals (HPs), especially those working in the front line, have been one of the groups most affected by the COVID-19 pandemic. The objective of this study is to identify the best available scientific evidence on the impact of the COVID-19 pandemic on the mental health of out-of-hospital HPs in terms of stress, anxiety, depression, and self-efficacy. A living systematic review of the literature was designed, consulting the electronic online versions of the CINHAL, Cochrane Library, Cuiden, IBECS, JBI, LILACS, Medline PyscoDoc, PsycoINFO, Scopus, and Web of Science databases in November 2021. Original research was selected, published in either English, Spanish, French, Italian, or Portuguese. In total, 2082 publications were identified, of which 16 were included in this review. The mental health of out-of-hospital HPs was affected. Being a woman or having direct contact with patients showing suspicious signs of COVID-19 or confirmed cases were the factors related to a greater risk of developing high levels of stress and anxiety; in the case of depressive symptoms, it was having a clinical history of illnesses that could weaken their defenses against infection. Stopping unpleasant emotions and thoughts was the coping strategy most frequently used by these HPs.
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Affiliation(s)
- Raúl Soto-Cámara
- Department of Health Sciences, University of Burgos, 09001 Burgos, Spain;
- Emergency Medical Service of Castilla y León—Sacyl, 47007 Valladolid, Spain; (H.O.-B.); (A.M.R.-M.); (M.M.-O.); (M.P.M.-H.); (A.M.-S.)
| | - Noemí García-Santa-Basilia
- Emergency Medical Service of Castilla y León—Sacyl, 47007 Valladolid, Spain; (H.O.-B.); (A.M.R.-M.); (M.M.-O.); (M.P.M.-H.); (A.M.-S.)
| | - Henar Onrubia-Baticón
- Emergency Medical Service of Castilla y León—Sacyl, 47007 Valladolid, Spain; (H.O.-B.); (A.M.R.-M.); (M.M.-O.); (M.P.M.-H.); (A.M.-S.)
| | - Rosa M. Cárdaba-García
- Emergency Medical Service of Castilla y León—Sacyl, 47007 Valladolid, Spain; (H.O.-B.); (A.M.R.-M.); (M.M.-O.); (M.P.M.-H.); (A.M.-S.)
- Nursing Department, Faculty of Nursing, University of Valladolid, 47005 Valladolid, Spain
| | - José Julio Jiménez-Alegre
- Emergency Medical Service of Madrid—SUMMA 112, 28045 Madrid, Spain; (J.J.J.-A.); (J.J.F.-D.); (S.N.-P.)
| | - Ana María Reques-Marugán
- Emergency Medical Service of Castilla y León—Sacyl, 47007 Valladolid, Spain; (H.O.-B.); (A.M.R.-M.); (M.M.-O.); (M.P.M.-H.); (A.M.-S.)
| | - María Molina-Oliva
- Emergency Medical Service of Castilla y León—Sacyl, 47007 Valladolid, Spain; (H.O.-B.); (A.M.R.-M.); (M.M.-O.); (M.P.M.-H.); (A.M.-S.)
| | | | - María Paz Matellán-Hernández
- Emergency Medical Service of Castilla y León—Sacyl, 47007 Valladolid, Spain; (H.O.-B.); (A.M.R.-M.); (M.M.-O.); (M.P.M.-H.); (A.M.-S.)
| | - Almudena Morales-Sanchez
- Emergency Medical Service of Castilla y León—Sacyl, 47007 Valladolid, Spain; (H.O.-B.); (A.M.R.-M.); (M.M.-O.); (M.P.M.-H.); (A.M.-S.)
| | - Susana Navalpotro-Pascual
- Emergency Medical Service of Madrid—SUMMA 112, 28045 Madrid, Spain; (J.J.J.-A.); (J.J.F.-D.); (S.N.-P.)
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Ghavami V, Kokabi Saghi F, Asghari A, Shabanikiya H. Predictors of nurses' reporting for work at the time of epidemics and natural disasters; solutions for hospital surge capacity. J Nurs Scholarsh 2021; 54:470-476. [PMID: 34796603 DOI: 10.1111/jnu.12746] [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: 03/27/2021] [Revised: 09/25/2021] [Accepted: 11/05/2021] [Indexed: 12/14/2022]
Abstract
PURPOSE To identify the predictors of nurses' presence at hospitals at the time of three types of disasters. DESIGN This cross-sectional study was performed using a researcher-generated questionnaire. METHODS This study was performed on 350 nurses of five public hospitals. Data was collected using a questionnaire in which the respondents were asked about their decisions on reporting for work in the event of three scenarios: epidemic of an unknown contagious respiratory disease, earthquake, and flood. Multiple logistic regression was used to analyze the data. FINDINGS The four predictors of nurses reporting for work include receiving trainings on disasters, and concerns on the non-compensation for providing services following the disaster, concerns about family safety and workplace safety. CONCLUSION Although slightly different factors affect the willingness of participants to report for work in each scenario, they can be put in two main categories; namely as personal and impersonal. Devising a family disaster plan and providing educational programs on self-care are two main strategies to increase the chances of presence at work following disasters. CLINICAL RELEVANCE The presence of more nurses in the hospital at the time of disasters can significantly improve the quality of care, and clinical outcomes of patients and disaster victims.
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Affiliation(s)
- Vahid Ghavami
- Department of Epidemiology and Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fatemeh Kokabi Saghi
- Department of Management Sciences and Health Economics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Asghari
- School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamidreza Shabanikiya
- Department of Management Sciences and Health Economics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
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Parvaresh-Masoud M, Imanipour M, Cheraghi MA. Emergency Medical Technicians' Experiences of the Challenges of Prehospital Care Delivery During the COVID-19 Pandemic: A Qualitative Study. Ethiop J Health Sci 2021; 31:1115-1124. [PMID: 35392330 PMCID: PMC8968364 DOI: 10.4314/ejhs.v31i6.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 03/29/2021] [Indexed: 11/17/2022] Open
Abstract
Background Exploring emergency medical technicians' (EMTs) experiences of COVID-19 epidemic, help to identify the challenges they face in their daily work and develop strategies that address these challenges. This study aimed to explore EMTs' experiences of the challenges of prehospital care delivery during the COVID-19 pandemic. Methods This qualitative study was conducted in March-July 2020 using conventional content analysis approach. Fifteen EMTs were purposively selected from the Emergency Medical Services (EMS) Center in Qom, Iran. For data collection, semi-structured interviews were conducted until data saturation was reached. Results EMTs' experiences of the challenges of prehospital care delivery during the COVID-19 pandemic were classified into three main categories including "restless society", "difficult care delivery conditions", and "unprepared organization". The emergent subcategories were "need for information", "limited perception of the COVID-19 risk", "obsessive use of disinfectants", "fear over the transmission of COVID-19 to self and others", "burnout due to heavy workload", "altered communication with hospital staff", "ethical conflicts", "lack of a definite treatment plan", "lack of protective equipment", "staff shortage due to the affliction of EMTs by COVID-19", and "inadequate support by authorities". Conclusion During COVID-19 pandemics, EMTs face many challenges including emotional and occupational stress, social strains, risk of affliction by infections, heavy workload, and ethical conflicts and hence, experience difficulties in quality care delivery. Developing appropriate strategies, guidelines, and policies are needed to effectively manage these challenges and improve the quality of prehospital care delivery in COVID-19 epidemic.
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Affiliation(s)
- Mohammad Parvaresh-Masoud
- Department of Critical Care and Management Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoomeh Imanipour
- Department of Critical Care and Management Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran, Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Cheraghi
- Department of Critical Care and Management Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
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Willingness to Work amongst Australian Frontline Healthcare Workers during Australia's First Wave of Covid-19 Community Transmission: Results of an Online Survey. Disaster Med Public Health Prep 2021; 17:e44. [PMID: 34496995 PMCID: PMC8545838 DOI: 10.1017/dmp.2021.288] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES The majority of research investigating healthcare workers' (HCWs) willingness to work during public health emergencies, asks participants to forecast their perceptions based on hypothetical emergencies, rather than in response to the actual public health emergencies they have experienced. This research explored frontline HCWs willingness to work during Australia's first wave of the COVID-19 pandemic among frontline HCWs. METHODS Participants (n = 580) completed an online questionnaire regarding their willingness to work during the pandemic. RESULTS A total of 42% of participants reported being less willing to work during the pandemic compared to before. Availability of personal protective equipment (PPE), concern expressed by family members, and viral exposure were significant barriers. A third of participants disagreed that some level of occupational risk for exposure to infectious disease was acceptable while a quarter of participants had received communications from their workplace concerning obligations to work during COVID-19. CONCLUSIONS The COVID-19 pandemic has impacted Australian frontline HCWs' willingness to work. Scarcity of PPE and exposure to the virus were the most cited reasons impacting on willingness to work. Appropriate policies and practices should be implemented and communicated efficiently to frontline HCW's. This research provides insight into the lived experiences of Australian healthcare professionals' willingness to work during a pandemic.
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Dreher A, Flake F, Pietrowsky R, Loerbroks A. Attitudes and stressors related to the SARS-CoV-2 pandemic among emergency medical services workers in Germany: a cross-sectional study. BMC Health Serv Res 2021; 21:851. [PMID: 34419024 PMCID: PMC8380100 DOI: 10.1186/s12913-021-06779-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 07/05/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim was to investigate attitudes and stressors related to the SARS-CoV-2 outbreak among emergency medical services (EMS) workers in Germany. We further aimed to detect possible changes within a 5-week period and potential determinants of attitudes and stressors. METHODS We conducted two cross-sectional studies using an online questionnaire in early April 2020 (i.e., the first peak of the SARS-CoV-2 outbreak in Germany) and five weeks later. The study instrument comprised sociodemographic items, self-devised items on pandemic-related attitudes, stressors and work outcomes, and established instruments assessing depressive symptoms and symptoms of anxiety. Logistic regression was performed to identify possible determinants. RESULTS Data of 1537 participants was included in the analysis (April: n = 1124, May: n = 413, 83.1% male, median age 32). Most participants agreed that their personal risk of infection was higher compared to the general population (April: 87.0% agreement, May: 78.9%). The greatest stressor was uncertainty about the pandemic's temporal scope (82.0 and 80.9%, respectively). Most participants (69.9, 79.7%) felt sufficiently prepared for the pandemic and only few felt burdened by their financial situation (18.8, 13.3%). Agreement to all stressors decreased from April to May except related to the childcare situation. Regression analysis identified subgroups to be burdened more frequently such as older employees, those with SARS-CoV-2 cases among their colleagues, and those with lower paramedic training levels. CONCLUSIONS We identified key SARS-CoV-2-related stressors whose levels generally decreased within a 5-week period. Our results indicate that EMS workers are less affected by existential fears and rather worry about their personal infection risk.
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Affiliation(s)
- Annegret Dreher
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Duesseldorf, Duesseldorf, Germany.
| | - Frank Flake
- German Association of Emergency Medical Service, Luebeck, Germany
| | - Reinhard Pietrowsky
- Institute of Experimental Psychology, Department of Clinical Psychology, University of Duesseldorf, Duesseldorf, Germany
| | - Adrian Loerbroks
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Duesseldorf, Duesseldorf, Germany
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15
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Mohammadi F, Tehranineshat B, Bijani M, Khaleghi AA. Management of COVID-19-related challenges faced by EMS personnel: a qualitative study. BMC Emerg Med 2021; 21:95. [PMID: 34391404 PMCID: PMC8363870 DOI: 10.1186/s12873-021-00489-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 08/04/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND As the first link in the chain of providing healthcare services in the frontline of the battle against COVID-19, emergency medical services (EMS) personnel are faced with various challenges, which affect their professional performance. The present study aimed to identify some strategies to manage the COVID-19-related challenges faced by the pre-hospital emergency care personnel in the south of Iran. METHODS In this qualitative descriptive study, 27 pre-hospital emergency care personnel who were selected through the purposeful sampling method. Data were collected through 27 semi-structured, in-depth, individual interviews. The collected data were then analyzed based on the Granheim and Lundman's method. RESULTS Analysis of the data resulted in the identification of 3 main themes and eight sub-themes. These three main themes were as follows: comprehensive and systematic planning, provision of medical equipment, and reduction of professional challenges. CONCLUSION The findings of the present study showed that, during the COVID-19 crisis, emergency medical services personnel should be provided with a comprehensive and systematic protocol to provide pre-hospital care and their performance should be assessed in terms of a set of scientific standards. Due to lack of equipment and work overload in the current crisis, emergency medical services personnel are faced with many psychological challenges, which adversely affect their quality of pre-hospital emergency care. Furthermore, emergency care senior managers should develop comprehensive protocols, provide more equipment, and eliminate professional challenges to pave the ground for improving the quality and safety of the healthcare services in pre-hospital emergency care during the current COVID-19 crisis.
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Affiliation(s)
- Fateme Mohammadi
- Department of Nursing, Hamadan University of Medical Sciences, Chronic Diseases (Home Care) Research Center and Autism Spectrum Disorders Research Center, Hamadan, Iran
| | - Banafsheh Tehranineshat
- Community-based Psychiatric Care Research Center, Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mostafa Bijani
- Department of Medical Surgical Nursing, Fasa University of Medical Sciences, Fasa, Iran
| | - Ali Asghar Khaleghi
- Non Communicable Diseases Research Center (NCDRC), Fasa University of Medical Sciences, Fasa, Iran
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16
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Beyramijam M, Farrokhi M, Ebadi A, Masoumi G, Khankeh HR. Disaster preparedness in emergency medical service agencies: A systematic review. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:258. [PMID: 34485555 PMCID: PMC8396056 DOI: 10.4103/jehp.jehp_1280_20] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 12/14/2020] [Indexed: 06/13/2023]
Abstract
The Emergency Medical Services (EMSs) are in the frontline between the health-care systems and people in emergencies and disasters. With the increase in the frequency of natural or man-made disasters around the world, the need for prepared EMS services is increasing. This study aimed to evaluate the current disaster preparedness status of the EMS agencies in the literature and exploring the key preparedness elements and the strategies to improve the EMS disaster preparedness. The electronic database such as PubMed, Web of Science, Scopus, and Google Scholar was searched from 2000 to 2019. The searching keywords included: "EMS," "Disaster," "Preparedness," "Emergency" "Preparedness," "Disaster Preparedness," "Readiness," and the terms related to "disaster types" were used in combination with Boolean operators OR and AND. Out of 1412 articles, 7 articles were included in the review. The most important elements of the EMS disaster preparedness include the size and scope of the incident, surge capacity, planning, communication, training and education, policymaking, financial support, coordination, safety and security, early warning system, disaster response experience, and legal considerations. This systematic review showed that the EMS agencies in the world generally are inadequately prepared for an effective response to major emergencies and disasters. This study provides valuable information to EMS educators, EMS administrators to adopt and perform appropriate activities to improve the EMS disaster preparedness.
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Affiliation(s)
- Mehdi Beyramijam
- Health in Emergency and Disaster Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mehrdad Farrokhi
- Health in Emergency and Disaster Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Abbas Ebadi
- Behavioral Sciences Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
- Nursing Faculty, Baqiyatallah University of Medical Scienses, Tehran, Iran
| | - Gholamreza Masoumi
- Health in Emergency and Disaster Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- Emergency Management Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hamid Reza Khankeh
- Health in Emergency and Disaster Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- Department of Clinical Science and Education, Karolinska Institute, Stockholm, Sweden
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Murray EJ, Mason M, Sparke V, Zimmerman PAP. Factors Influencing Health Care Workers' Willingness to Respond to Duty during Infectious Disease Outbreaks and Bioterrorist Events: An Integrative Review. Prehosp Disaster Med 2021; 36:321-337. [PMID: 33618789 PMCID: PMC7948100 DOI: 10.1017/s1049023x21000248] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 01/16/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND Infectious disease emergencies are increasingly becoming part of the health care delivery landscape, having implications to not only individuals and the public, but also on those expected to respond to these emergencies. Health care workers (HCWs) are perhaps the most important asset in an infectious disease emergency, yet these individuals have their own barriers and facilitators to them being willing or able to respond. AIM The purpose of this review was to identify factors affecting HCW willingness to respond (WTR) to duty during infectious disease outbreaks and/or bioterrorist events. METHODS An integrative literature review methodology was utilized to conduct a structured search of the literature including CINAHL, Medline, Embase, and PubMed databases using key terms and phrases. PRISMA guidelines were used to report the search outcomes and all eligible literature was screened with those included in the final review collated and appraised using a quality assessment tool. RESULTS A total of 149 papers were identified from the database search. Forty papers were relevant following screening, which highlighted facilitators of WTR to include: availability of personal protective equipment (PPE)/vaccine, level of training, professional ethics, family and personal safety, and worker support systems. A number of barriers were reported to prevent WTR for HCWs, such as: concern and perceived risk, interpersonal factors, job-level factors, and outbreak characteristics. CONCLUSIONS By comprehensively identifying the facilitators and barriers to HCWs' WTR during infectious disease outbreaks and/or bioterrorist events, strategies can be identified and implemented to improve WTR and thus improve HCW and public safety.
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Affiliation(s)
- Eleanor J. Murray
- Department of Epidemiology, Boston University School of Public Health, Boston, MassachusettsUSA
| | - Matt Mason
- School of Nursing, Midwifery, and Paramedicine, University of the Sunshine Coast, Maroochydore DC, Queensland, Australia
- Collaborative for the Advancement of Infection Prevention and Control, Queensland, Australia
| | - Vanessa Sparke
- Collaborative for the Advancement of Infection Prevention and Control, Queensland, Australia
- Discipline of Nursing and Midwifery, James Cook University, Cairns, Queensland, Australia
| | - Peta-Anne P. Zimmerman
- Collaborative for the Advancement of Infection Prevention and Control, Queensland, Australia
- School of Nursing and Midwifery, Griffith University, Gold Coast, Queensland, Australia
- Gold Coast Hospital and Health Service, Southport, Queensland, Australia
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Newberry JA, Gautreau M, Staats K, Carrillo E, Mulkerin W, Yang S, Kohn MA, Matheson L, Boyd SD, Pinsky BA, Blomkalns AL, Strehlow MC, D'Souza PA. SARS-CoV-2 IgG Seropositivity and Acute Asymptomatic Infection Rate among Firefighter First Responders in an Early Outbreak County in California. PREHOSP EMERG CARE 2021:1-10. [PMID: 33819128 DOI: 10.1080/10903127.2021.1912227] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/29/2021] [Accepted: 03/30/2021] [Indexed: 10/21/2022]
Abstract
Objective: Firefighter first responders and other emergency medical services (EMS) personnel have been among the highest risk healthcare workers for illness during the SARS-CoV-2 pandemic. We sought to determine the rate of seropositivity for SARS-CoV-2 IgG antibodies and of acute asymptomatic infection among firefighter first responders in a single county with early exposure in the pandemic. Methods: We conducted a cross-sectional study of clinically active firefighters cross-trained as paramedics or EMTs in the fire departments of Santa Clara County, California. Firefighters without current symptoms were tested between June and August 2020. Our primary outcomes were rates of SARS-CoV-2 IgG antibody seropositivity and SARS-CoV-2 RT-PCR swab positivity for acute infection. We report cumulative incidence, participant characteristics with frequencies and proportions, and proportion positive and associated relative risk (with 95% confidence intervals). Results: We enrolled 983 out of 1339 eligible participants (response rate: 73.4%). Twenty-five participants (2.54%, 95% CI 1.65-3.73) tested positive for IgG antibodies and 9 (0.92%, 95% CI 0.42-1.73) tested positive for SARS-CoV-2 by RT-PCR. Our cumulative incidence, inclusive of self-reported prior positive PCR tests, was 34 (3.46%, 95% CI 2.41-4.80). Conclusion: In a county with one of the earliest outbreaks in the United States, the seroprevalence among firefighter first responders was lower than that reported by other studies of frontline health care workers, while the cumulative incidence remained higher than that seen in the surrounding community.
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19
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Cash RE, Rivard MK, Camargo CA, Powell JR, Panchal AR. Emergency Medical Services Personnel Awareness and Training about Personal Protective Equipment during the COVID-19 Pandemic. PREHOSP EMERG CARE 2021; 25:777-784. [PMID: 33211613 DOI: 10.1080/10903127.2020.1853858] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Background: With the emergence of the 2019 novel coronavirus disease (COVID-19), appropriate training for emergency medical services (EMS) personnel on personal protective equipment (PPE) is essential. We aimed: 1) to examine the change in proportions of EMS personnel reporting awareness of and training in PPE during the COVID-19 pandemic; and 2) to determine factors associated with reporting these outcomes.We conducted a cross-sectional analysis of data collected from October 1, 2019 to June 30, 2020 from currently working, nationally certified EMS personnel (n = 15,339), assessing N95 respirator fit testing; training in air purified respirators (APR) or powered APR (PAPR) use; and training on PPE use for chemical, biological, and nuclear (CBN) threats. We used an interrupted time series analysis to determine changes in proportions of EMS personnel reporting training per week, using the date of Centers for Disease Control and Prevention's (CDC) initial EMS guidance (February 6, 2020) as the interruption. We fit multivariable logistic regression models to understand factors associated with each outcome.Results: We found high awareness of N95 respirators (99%) and APR/PAPR (91%), but only 61% reported N95 fit testing and 64% reported training on PPE for CBN threats in the prior 12 months. There was a significant, positive slope change after CDC guidance for N95 respirator fit testing, and significant post-interruption mean increases for fit testing (0.9%, 95% CI 0.6-1.1%), APR/PAPR training (0.3%, 95% CI 0.2-0.5%), and PPE for CBN threats training (0.6%, 95% CI 0.3-0.9%). Factors consistently associated with lower odds of awareness/training included part-time employment, providing 9-1-1 response service, working at a non-fire-based EMS agency, and working in a rural setting.Conclusions: CDC guidance on COVID-19 for EMS may have increased N95 fit testing and training, but there remain substantial gaps in training on PPE use among EMS personnel. As the pandemic continues in our communities, EMS agencies should be supported in efforts to adequately prepare their staff.
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20
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Goniewicz K, Goniewicz M, Włoszczak-Szubzda A, Burkle FM, Hertelendy AJ, Al-Wathinani A, Molloy MS, Khorram-Manesh A. The importance of pre-training gap analyses and the identification of competencies and skill requirements of medical personnel for mass casualty incidents and disaster training. BMC Public Health 2021; 21:114. [PMID: 33422033 PMCID: PMC7796807 DOI: 10.1186/s12889-021-10165-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 01/04/2021] [Indexed: 12/29/2022] Open
Abstract
Background Effective preparedness to respond to mass casualty incidents and disasters requires a well-planned and integrated effort by all involved professionals, particularly those who are working in healthcare, who are equipped with unique knowledge and skills for emergencies. This study aims to investigate and evaluate the level of knowledge and skills related to mass casualty and disaster management in a cohort of healthcare professionals. Methods A cross-sectional brief study was conducted using a validated and anonymous questionnaire, with a sample of 134 employees at a clinical hospital in Lublin, Poland. Results The findings of this study may indicate a need for standardization of training for hospitals employees. It also suggests a knowledge gap between different professional groups, which calls for adjusting such general training, to at least, the weakest group, while special tasks and mission can be given to other groups within the training occasion. Conclusion Pre-Training gap analyses and identification of participants’ competencies and skills should be conducted prior to training in mass casualty incidents and disasters. Such analyses provides an opportunity to develop training curriculum at various skill and knowledge levels from basic to advance. All training in mass casualty incidents and disasters should be subject to ongoing, not just periodic, evaluation, in order to assess continued competency. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10165-5.
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Affiliation(s)
- Krzysztof Goniewicz
- Department of Aviation Security, Military University of Aviation, 08-521, Dęblin, Poland.
| | - Mariusz Goniewicz
- Department of Emergency Medicine, Medical University of Lublin, 20-059, Lublin, Poland
| | | | - Frederick M Burkle
- Harvard Humanitarian Initiative, T.H. Chan School of Public Health, Harvard University, Boston, MA, 02115, USA
| | - Attila J Hertelendy
- Department of Information Systems and Business Analytics, College of Business, Florida International University, Miami, FL, 33174, USA
| | - Ahmed Al-Wathinani
- Department of Emergency Medical Services, Prince Sultan Bin Abdulaziz College for Emergency Medical Services, King Saud University, Riyadh, 11451, Saudi Arabia
| | - Michael Sean Molloy
- Department of Emergency Medicine, Wexford General Hospital, Wexford, Y35 Y17D, Ireland.,School of Medicine, University College Dublin, Donnybrook, D4, Ireland.,BIDMC Fellowship in Disaster Medicine, Department of Emergency Medicine, Beth Israel Deaconess Medical Centre, 457 Brookline Avenue, Boston, MA, 02215, USA
| | - Amir Khorram-Manesh
- Institute of Clinical Sciences, Department of Surgery, Sahlgrenska Academy, Gothenburg University, 413 45, Gothenburg, Sweden.,Research Advisor, Department of Development and Research, Armed Forces Center for Defense Medicine, 426 76, Gothenburg, Västra Frölunda, Sweden
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21
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Balut MD, Der-Martirosian C, Dobalian A. Determinants of Workforce Preparedness during Pandemics Among Healthcare Workers at the U.S. Department of Veterans Affairs. J Prim Care Community Health 2021; 12:21501327211004738. [PMID: 33759623 PMCID: PMC8010801 DOI: 10.1177/21501327211004738] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/02/2021] [Accepted: 03/04/2021] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE An infectious disease outbreak can place a significant burden on healthcare systems, however, our understanding of the broader healthcare workforce's preparedness during a pandemic is limited. This study examines factors that influence perceived workforce preparedness at the U.S. Department of Veterans Affairs (VA) during a pandemic. METHODS The VA Preparedness Survey was a random, anonymous, web-based survey fielded nationwide October to December 2018. Multivariate statistical analyses examined the effects of study relevant factors (sociodemographic, work-related, general health, and household-related characteristics of VA employees) on perceptions of workforce preparedness, including institutional readiness and understanding of individual roles during a pandemic. RESULTS Four thousand and twenty-six VA employees responded. Overall, 55% were confident in their VA medical facility's ability to respond; 49% understood their role; and 68% reported their role to be important during a pandemic. After controlling for study-relevant factors, household preparedness, having plans that address the health care needs of family members, and higher self-reported health status were associated with all 3 workforce preparedness variables. Clinical staff (compared to non-clinical staff) were less likely (OR:0.80, 95% CI:0.68-0.94, P < .01) to have confidence in their medical facility's ability to respond but more likely (OR:1.77, 95% CI:1.49-2.10, P < .001) to believe their role was important. Employees who have been at the VA longer (OR:1.07, 95% CI:1.01-1.14, P < .05) or have experienced a disaster while working at the VA (OR:1.29, 95% CI:1.04-1.59, P < .05) were more likely to understand their role during a pandemic. CONCLUSION The findings from this study suggest the need for identifying ways to increase VA employees' confidence in their medical facility's ability to respond to a pandemic; develop trainings to improve understanding of their different yet critical roles, for both clinical and non-clinical staff, during a pandemic; create different workforce trainings for newly hired employees; and identify ways to improve household preparedness for a pandemic outbreak.
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Affiliation(s)
- Michelle D. Balut
- Veterans Emergency Management Evaluation Center, North Hills, CA, USA
| | | | - Aram Dobalian
- Veterans Emergency Management Evaluation Center, North Hills, CA, USA
- University of Memphis School of Public Health, Memphis, TN, USA
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