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Samuel IBH, Pollin K, Tschida S, Prisco MK, Lu C, Powell A, Mefford J, Lee J, Dupriest T, Forsten R, Ortiz J, Barrett J, Reinhard M, Costanzo M. Linked Exposures Across Databases: an exposure common data elements aggregation framework to facilitate clinical exposure review. Front Public Health 2024; 12:1408222. [PMID: 39005996 PMCID: PMC11243485 DOI: 10.3389/fpubh.2024.1408222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 05/21/2024] [Indexed: 07/16/2024] Open
Abstract
Understanding the health outcomes of military exposures is of critical importance for Veterans, their health care team, and national leaders. Approximately 43% of Veterans report military exposure concerns to their VA providers. Understanding the causal influences of environmental exposures on health is a complex exposure science task and often requires interpreting multiple data sources; particularly when exposure pathways and multi-exposure interactions are ill-defined, as is the case for complex and emerging military service exposures. Thus, there is a need to standardize clinically meaningful exposure metrics from different data sources to guide clinicians and researchers with a consistent model for investigating and communicating exposure risk profiles. The Linked Exposures Across Databases (LEAD) framework provides a unifying model for characterizing exposures from different exposure databases with a focus on providing clinically relevant exposure metrics. Application of LEAD is demonstrated through comparison of different military exposure data sources: Veteran Military Occupational and Environmental Exposure Assessment Tool (VMOAT), Individual Longitudinal Exposure Record (ILER) database, and a military incident report database, the Explosive Ordnance Disposal Information Management System (EODIMS). This cohesive method for evaluating military exposures leverages established information with new sources of data and has the potential to influence how military exposure data is integrated into exposure health care and investigational models.
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Affiliation(s)
- Immanuel B H Samuel
- The Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, MD, United States
- The War Related Illness and Injury Study Center, Washington, DC, United States
- Complex Exposure Threats Center, Department of Veterans Affairs, Washington, DC, United States
| | - Kamila Pollin
- The War Related Illness and Injury Study Center, Washington, DC, United States
| | - Sherri Tschida
- The War Related Illness and Injury Study Center, Washington, DC, United States
- Complex Exposure Threats Center, Department of Veterans Affairs, Washington, DC, United States
| | | | - Calvin Lu
- The Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, MD, United States
- The War Related Illness and Injury Study Center, Washington, DC, United States
- Complex Exposure Threats Center, Department of Veterans Affairs, Washington, DC, United States
| | - Alan Powell
- Explosive Ordnance Disposal Information Management System (EODIMS), Air Force Civil Engineer Center, Functional Management Office (FMO) (AFCEC/CBS), Joint Base San Antonio, San Antonio, TX, United States
| | - Jessica Mefford
- Explosive Ordnance Disposal Information Management System (EODIMS), Air Force Civil Engineer Center, Functional Management Office (FMO) (AFCEC/CBS), Joint Base San Antonio, San Antonio, TX, United States
| | - Jamie Lee
- Explosive Ordnance Disposal Information Management System (EODIMS), Air Force Civil Engineer Center, Functional Management Office (FMO) (AFCEC/CBS), Joint Base San Antonio, San Antonio, TX, United States
| | - Teresa Dupriest
- Explosive Ordnance Disposal Information Management System (EODIMS), Air Force Civil Engineer Center, Functional Management Office (FMO) (AFCEC/CBS), Joint Base San Antonio, San Antonio, TX, United States
| | - Robert Forsten
- The War Related Illness and Injury Study Center, Washington, DC, United States
- Complex Exposure Threats Center, Department of Veterans Affairs, Washington, DC, United States
- Department of Psychiatry, Uniformed Services University, Bethesda, MD, United States
| | - Jose Ortiz
- The War Related Illness and Injury Study Center, Washington, DC, United States
- Complex Exposure Threats Center, Department of Veterans Affairs, Washington, DC, United States
| | - John Barrett
- The War Related Illness and Injury Study Center, Washington, DC, United States
- Complex Exposure Threats Center, Department of Veterans Affairs, Washington, DC, United States
- Department of Medicine, Uniformed Services University, Bethesda, MD, United States
| | - Matthew Reinhard
- The War Related Illness and Injury Study Center, Washington, DC, United States
- Complex Exposure Threats Center, Department of Veterans Affairs, Washington, DC, United States
- Georgetown University Medical School, Washington, DC, United States
| | - Michelle Costanzo
- The War Related Illness and Injury Study Center, Washington, DC, United States
- Complex Exposure Threats Center, Department of Veterans Affairs, Washington, DC, United States
- Department of Medicine, Uniformed Services University, Bethesda, MD, United States
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Golder J, Jerge M, Sundstrom B, Dziobak M, Hart LB. Factors influencing CDC- recommended preventative behaviors through the COVID-19 pandemic in college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-9. [PMID: 38683887 DOI: 10.1080/07448481.2024.2346340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 04/09/2024] [Indexed: 05/02/2024]
Abstract
Objective: To understand how student perceptions of physical health and generalized concern about infection influenced engagement in COVID-19 preventive behaviors. Participants: 418 full-time undergraduate and graduate students attending a public university in South Carolina, USA. Methods: A self-administered survey was distributed during the 2020-2021 academic year. The health belief model, structural equation modeling, and regression methods were used to evaluate associations between students' perceived physical health and the use of CDC-recommended mitigation strategies. Results: Our findings suggest that an individual's perception of their own physical health impacted engagement in preventive behaviors by influencing concerns about disease severity (p = 0.01) and susceptibility (p = 0.03). However, perceived physical health was not associated with perceived benefits (p = 0.21), barriers (p = 0.57), or self-efficacy (p = 0.62) of mitigation strategies. Conclusions: Intrapersonal factors may play a strong role in the way a student undertakes disease control and prevention.
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Affiliation(s)
- J Golder
- Department of Health and Human Performance, College of Charleston, Charleston, SC, USA
- Honors College, College of Charleston, Charleston, SC, USA
| | - M Jerge
- Department of Health and Human Performance, College of Charleston, Charleston, SC, USA
- Honors College, College of Charleston, Charleston, SC, USA
| | - B Sundstrom
- Department of Communication, College of Charleston, Charleston, SC, USA
| | - M Dziobak
- Environmental and Sustainability Studies Graduate Program, College of Charleston, Charleston, SC, USA
- Department of Environmental Health Sciences, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - L B Hart
- Department of Health and Human Performance, College of Charleston, Charleston, SC, USA
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Dempster P, Hutchinson A, Oldland E, Bouchoucha SL. Australian emergency nurses' experiences of working with personal protective equipment during the COVID-19 pandemic. A qualitative study. Australas Emerg Care 2024; 27:63-70. [PMID: 37679286 DOI: 10.1016/j.auec.2023.08.003] [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: 06/11/2023] [Revised: 08/16/2023] [Accepted: 08/20/2023] [Indexed: 09/09/2023]
Abstract
INTRODUCTION The COVID-19 pandemic has exposed a need to understand the challenges associated with wearing Personal protective Equipment (PPE). The aim in this study was to explore emergency nurses' experiences early in the COVID-19 pandemic in Australia and the impact of PPE use on their practice. METHODS An explorative descriptive qualitative study was conducted between January 2022 and April 2022. Eighteen emergency nurses and six leaders participated. Semi-structured interviews (n = 21) and one focus group were conducted. Interview transcripts were analysed using Braun and Clarke's framework. RESULTS Two major themes were identified. The first theme was: (1) The shifting ground of the COVID-19 pandemic response. Associated sub-themes were: i) What's the go with PPE today? ii) In the beginning we were scrambling for masks; iii) Emergency is the true frontline. The second theme was: (2) Physical and emotional impacts of emergency nursing work. Sub-themes were: (i) Facing the fear of exposure; (ii) By the end of the shift I am just absolutely spent; iii) Discomfort of wearing PPE impacts on compliance. CONCLUSIONS Healthcare leaders need to secure PPE supply chains and evaluate the effectiveness and side-effects of different PPE designs to minimise occupational harms associated with prolonged PPE use.
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Affiliation(s)
- Penelope Dempster
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, Australia; Holmesglen Institute of TAFE.
| | - Ana Hutchinson
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, Australia; Centre for Quality and Patient Safety Research, Epworth Healthcare Partnership, Deakin University, Geelong, Australia; Centre for Innovation in Infectious Disease and Immunology Research (CIIDIR), Deakin University, Geelong, Australia
| | - Elizabeth Oldland
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Stéphane L Bouchoucha
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, Australia; Centre for Innovation in Infectious Disease and Immunology Research (CIIDIR), Deakin University, Geelong, Australia
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Sansone V, Miraglia del Giudice G, Della Polla G, Angelillo IF. Impact of the COVID-19 pandemic on behavioral changes in healthcare workers in Italy. Front Public Health 2024; 12:1335953. [PMID: 38384871 PMCID: PMC10879601 DOI: 10.3389/fpubh.2024.1335953] [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: 11/09/2023] [Accepted: 01/09/2024] [Indexed: 02/23/2024] Open
Abstract
Introduction During the COVID-19 pandemic, adherence to wearing face mask and washing hands procedures and achieving high COVID-19 vaccine coverage among healthcare workers (HCWs) were essential to minimize morbidity and possible death and limit the transmission of the virus. The objectives of the cross-sectional survey were to explore the influence of COVID-19 on the use of preventive measures and vaccination willingness among HCWs in the southern part of Italy and the associated factors. Methods The survey was carried out from 15 June 2023 to 15 July 2023 among 521 HCWs who worked in three randomly selected public hospitals. All data were collected through a self-administered questionnaire. Results HCWs had a positive change in the use of preventive measures if they did not often/always use them before the pandemic, but they are using in the current epidemiologic context and they were willing to use in a future epidemic situation. A positive change in the adherence to face mask-wearing (24.6%) was more likely among those with at least 5 years of university degree, nurses/midwives, and who had worked in COVID-19 wards. A positive change in alcohol-based hand rubbing (3.1%) was more likely in HCWs in Emergency/Critical/Infectious Diseases wards compared with medical wards. HCWs who were more likely to believe that the COVID-19 vaccine should be mandatory for them (58.1%) had at least 5 years of university degree, in Emergency/Critical/Infectious Diseases wards compared with surgical and medical wards, had received more than three doses of this vaccine, were more concerned to get infected during their activity, and had received information from scientific journals. HCWs more willing to receive the COVID-19 vaccine every year (39.8%) were males, physicians, those in Emergency/Critical/Infectious Diseases wards compared with medical wards, who had received more than three doses of this vaccine, who believed that this vaccine should be mandatory for HCWs, and who needed additional information. Discussion The survey showed that the COVID-19 pandemic had an impact on the use of preventive measures among HCWs, not necessarily for the improvement or increase. Educational messages on the importance of these measures regarding the promotion and recommendation of the vaccine need to be investigated and applied among HCWs in order to reduce vaccination gaps and the spread of the infection.
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Webber V. Sex exceptionalism and erasure in porn health protocols. CULTURE, HEALTH & SEXUALITY 2024; 26:126-141. [PMID: 36995128 DOI: 10.1080/13691058.2023.2191262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 03/12/2023] [Indexed: 03/31/2023]
Abstract
Porn production, like all forms of labour, entails certain occupational health and safety (OHS) risks. Porn production has generally not been subject to state occupational health oversight, and porn workers have instead implemented self-regulatory OHS systems. However, in California, where the industry is most established, governmental and non-governmental bodies have made several paternalist attempts to legislate standardised OHS protocols. Their proposed legislation exceptionalises sex work as uniquely dangerous while failing to tailor guidance to the specific needs of and practices associated with porn work. This is largely because: 1) regulators are ignorant of porn's self-regulatory processes; 2) industry self-regulation conceptualises the occupational hazard on porn sets as infectious bodily fluids, whereas external regulators perceive the hazard as sex itself; and 3) regulators devalue porn work and so do not take the viability of the labour into account when evaluating protocol effectiveness. Using critical-interpretive medical anthropology involving fieldwork and interviews with porn workers and a critical analysis of porn OHS texts, I argue that porn health protocols should be left to industry self-determination, to be developed by porn workers rather than for them.
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Affiliation(s)
- Valerie Webber
- Faculty of Medicine, Memorial University, St. John's, NL, Canada
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Xu Y, Liu WJ, Wang X, Yang QM. Occupational protection behavior and its influencing factors of newly recruited nurses. BMC MEDICAL EDUCATION 2023; 23:797. [PMID: 37880657 PMCID: PMC10601324 DOI: 10.1186/s12909-023-04780-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 10/16/2023] [Indexed: 10/27/2023]
Abstract
AIM Aim The objective of this study was to understand the occupational protective behaviors of newly recruited nurses and explore the influencing factors. METHODS A convenience sampling method was used to select newly recruited nurses in our hospital from July 2018 to November 2019. The survey was conducted using the general information questionnaire, work attitude scale (Wa), and occupational protective behavior scale. RESULTS The total score of occupational protective behaviors of 150 newly enrolled nurses was 18.94 ± 3.59. There was a significant negative correlation between work attitude score and occupational protective behaviors (r = -0.324, p < 0.001). Multiple linear regression analysis showed that gender, previous participation in nursing skill-based competitions, experience of needlestick injuries before recruit, work attitude score, average daily sleep time (p < 0.05) were independent factors influencing occupational protective behaviors. CONCLUSIONS The overall occupational protective awareness of newly enrolled nurses is relatively weak and needs to be further improved. The group's ability to improve occupational protective behaviors may be positively impacted through increased adaptability, improved sleep, active participation in nursing skill-based competitions, strengthening guidance and education on occupational protection.
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Affiliation(s)
- Yang Xu
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
- School of Nursing, West China Hospital of Sichuan University, Chengdu, Sichuan, PR China
| | - Wen-Jie Liu
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
- School of Nursing, West China Hospital of Sichuan University, Chengdu, Sichuan, PR China
| | - Xia Wang
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
- School of Nursing, West China Hospital of Sichuan University, Chengdu, Sichuan, PR China
| | - Qian-Mei Yang
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China.
- School of Nursing, West China Hospital of Sichuan University, Chengdu, Sichuan, PR China.
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Drouard SHP, Ahmed T, Amor Fernandez P, Baral P, Peters M, Hansen P, Hashemi T, Sieleunou I, Iyabode Ogunlayi M, Karibwami AD, Ruel Bergeron J, Montufar Velarde EE, Yansane ML, Wesseh CS, Mwansambo C, Nzelu C, Uddin H, Tassembedo M, Shapira G. Availability and use of personal protective equipment in low- and middle-income countries during the COVID-19 pandemic. PLoS One 2023; 18:e0288465. [PMID: 37459298 PMCID: PMC10351736 DOI: 10.1371/journal.pone.0288465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 06/27/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Availability and appropriate use of personal protective equipment (PPE) is of particular importance in Low and Middle-Income countries (LMICs) where disease outbreaks other than COVID-19 are frequent and health workers are scarce. This study assesses the availability of necessary PPE items during the COVID-19 pandemic at health facilities in seven LMICs. METHODS Data were collected using a rapid-cycle survey among 1554 health facilities in seven LMICs via phone-based surveys between August 2020 and December 2021. We gathered data on the availability of World Health Organization (WHO)-recommended PPE items and the use of items when examining patients suspected to be infected with COVID-19. We further investigated the implementation of service adaptation measures in a severe shortage of PPE. RESULTS There were major deficiencies in PPE availability at health facilities. Almost 3 out of 10 health facilities reported a stock-out of medical masks on the survey day. Forty-six percent of facilities did not have respirator masks, and 16% did not have any gloves. We show that only 43% of health facilities had sufficient PPE to comply with WHO guidelines. Even when all items were available, healthcare workers treating COVID-19 suspected patients were reported to wear all the recommended equipment in only 61% of health facilities. We did not find a statistically significant difference in implementing service adaptation measures between facilities experiencing a severe shortage or not. CONCLUSION After more than a year into the COVID-19 pandemic, the overall availability of PPE remained low in our sample of low and middle-income countries. Although essential, the availability of PPE did not guarantee the proper use of the equipment. The lack of PPE availability and improper use of available PPE enable preventable COVID-19 transmission in health facilities, leading to greater morbidity and mortality and risking the continuity of service delivery by healthcare workers.
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Affiliation(s)
| | - Tashrik Ahmed
- Global Financing Facility for Women, Children, and Adolescents
| | | | - Prativa Baral
- Global Financing Facility for Women, Children, and Adolescents
| | - Michael Peters
- Global Financing Facility for Women, Children, and Adolescents
| | - Peter Hansen
- Global Financing Facility for Women, Children, and Adolescents
| | - Tawab Hashemi
- Global Financing Facility for Women, Children, and Adolescents
| | | | | | | | | | | | | | | | | | | | - Helal Uddin
- Directorate General of Health Services, Dhaka, Bangladesh
| | | | - Gil Shapira
- World Bank Group, Washington, DC, United States of America
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Yosef T, Shifera N. Personal Protective Equipment Utilization and Associated Factors among Industry Park Construction Workers in Northwest Ethiopia. ENVIRONMENTAL HEALTH INSIGHTS 2023; 17:11786302231185683. [PMID: 37434665 PMCID: PMC10331180 DOI: 10.1177/11786302231185683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 06/15/2023] [Indexed: 07/13/2023]
Abstract
Introduction Equipment that safeguards the user from the risk of accidents or harmful health effects is known as personal protective equipment. Reports show personal protective equipment utilization is low in Africa. Workers are exposed to a wide range of physical, chemical, and incidental hazards because of low utilization of personal protective equipment. Therefore, this study aimed to assess the magnitude and factors associated with personal protective equipment utilization among Bure Industrial Park construction workers, Northwest Ethiopia. Methods A cross-sectional study involving 368 construction workers was carried out. The questionnaire was prepared to collect data on sociodemographic, work-related, and behavioral characteristics. Personal protective equipment usage was assessed by observation. Descriptive statistics' frequencies, proportions, and means were computed, and the analysis results were presented in text and tables. To find independent variables associated with personal protective equipment utilization, bi-variable and multivariable logistic regression analyses were performed. Results The proportion of workers at the Bure Industrial Park who utilized personal protective equipment was 47.8%, 95% CI (47.7-47.9). After adjusting employment type as a confounding factor; not being a substance user [AOR = 9.52, 95% CI (5.07-17.8)], regular workplace supervision [AOR = 4.09, 95% CI (1.26-5.48)], having occupational safety training [AOR = 6.01, 95% CI (2.05-17.6)], and provision of personal protective equipment at workplace [AOR = 7.36, 95% CI (3.97-13.6)] were the factors associated with personal protective equipment utilization. Conclusion and recommendation Nearly 1 in 2 workers wear PPE at work. Lack of PPE utilization is a public health problem in the study area. According to the study, personal protective equipment utilization was influenced by behavioral and occupational factors. To increase the utilization of personal protective equipment, training in safety procedures and regular workplace supervision must be considered.
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Affiliation(s)
- Tewodros Yosef
- School of Public Health, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan Teferi, Ethiopia
- School of Medicine, Faculty of Health, Deakin University, Waurn Ponds, Australia
| | - Nigusie Shifera
- School of Public Health, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan Teferi, Ethiopia
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Laroche E, Fournier PS, Ouedraogo NC. Prediction of compliance with preventive measures among teachers in the context of the COVID-19 pandemic. TECHNOLOGICAL FORECASTING AND SOCIAL CHANGE 2023; 192:122564. [PMID: 37065093 PMCID: PMC10080279 DOI: 10.1016/j.techfore.2023.122564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 02/10/2023] [Accepted: 02/16/2023] [Indexed: 05/21/2023]
Abstract
The objective of this study is to examine, in primary and high schools, teachers' compliance with preventive infection control measures (in the context of the COVID-19 pandemic). Inspired by the technology acceptance model (TAM) and occupational health and safety (OHS) literature on personal protective equipment (PPE) use, we propose a model of compliance with preventive measures among teachers. Data were collected following an observational, cross-sectional design. The data for the study were collected via a questionnaire survey of teachers working in the province of Quebec, Canada. To study the impact of the explanatory variables on the dependent variable, we developed a multiple linear regression model. This model was estimated to assess the preventive measures as a whole (six items). Results show that having tested positive for a COVID test in the last year, judging that the situation does not require the use of the mask or the protective glasses, training received on preventive measures, factors related to comfort and use of protective eyewear, as well as age influence teacher compliance with COVID-19 preventive measures.
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Affiliation(s)
- Elena Laroche
- Faculty of Administrative Sciences, Laval University, Pavillon Palasis-Prince (local 0523), 2325 rue de la Terrasse, Québec G1V 0A6, Canada
| | - Pierre-Sébastien Fournier
- Faculty of Administrative Sciences, Laval University, Pavillon Palasis-Prince (local 0523), 2325 rue de la Terrasse, Québec G1V 0A6, Canada
| | - Nafissatou Cynthia Ouedraogo
- Faculty of Administrative Sciences, Laval University, Pavillon Palasis-Prince (local 0523), 2325 rue de la Terrasse, Québec G1V 0A6, Canada
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Valenzuela-Fernández A, Cabrera-Rodriguez R, Ciuffreda L, Perez-Yanes S, Estevez-Herrera J, González-Montelongo R, Alcoba-Florez J, Trujillo-González R, García-Martínez de Artola D, Gil-Campesino H, Díez-Gil O, Lorenzo-Salazar JM, Flores C, Garcia-Luis J. Nanomaterials to combat SARS-CoV-2: Strategies to prevent, diagnose and treat COVID-19. Front Bioeng Biotechnol 2022; 10:1052436. [PMID: 36507266 PMCID: PMC9732709 DOI: 10.3389/fbioe.2022.1052436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 11/09/2022] [Indexed: 11/26/2022] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the associated coronavirus disease 2019 (COVID-19), which severely affect the respiratory system and several organs and tissues, and may lead to death, have shown how science can respond when challenged by a global emergency, offering as a response a myriad of rapid technological developments. Development of vaccines at lightning speed is one of them. SARS-CoV-2 outbreaks have stressed healthcare systems, questioning patients care by using standard non-adapted therapies and diagnostic tools. In this scenario, nanotechnology has offered new tools, techniques and opportunities for prevention, for rapid, accurate and sensitive diagnosis and treatment of COVID-19. In this review, we focus on the nanotechnological applications and nano-based materials (i.e., personal protective equipment) to combat SARS-CoV-2 transmission, infection, organ damage and for the development of new tools for virosurveillance, diagnose and immune protection by mRNA and other nano-based vaccines. All the nano-based developed tools have allowed a historical, unprecedented, real time epidemiological surveillance and diagnosis of SARS-CoV-2 infection, at community and international levels. The nano-based technology has help to predict and detect how this Sarbecovirus is mutating and the severity of the associated COVID-19 disease, thereby assisting the administration and public health services to make decisions and measures for preparedness against the emerging variants of SARS-CoV-2 and severe or lethal COVID-19.
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Affiliation(s)
- Agustín Valenzuela-Fernández
- Laboratorio de Inmunología Celular y Viral, Unidad de Farmacología, Sección de Medicina, Facultad de Ciencias de la Salud, Universidad de La Laguna, San Cristóbal de La Laguna, Spain
| | - Romina Cabrera-Rodriguez
- Laboratorio de Inmunología Celular y Viral, Unidad de Farmacología, Sección de Medicina, Facultad de Ciencias de la Salud, Universidad de La Laguna, San Cristóbal de La Laguna, Spain
| | - Laura Ciuffreda
- Research Unit, Hospital Universitario N. S. de Candelaria, Santa Cruz de Tenerife, Spain
| | - Silvia Perez-Yanes
- Laboratorio de Inmunología Celular y Viral, Unidad de Farmacología, Sección de Medicina, Facultad de Ciencias de la Salud, Universidad de La Laguna, San Cristóbal de La Laguna, Spain
| | - Judith Estevez-Herrera
- Laboratorio de Inmunología Celular y Viral, Unidad de Farmacología, Sección de Medicina, Facultad de Ciencias de la Salud, Universidad de La Laguna, San Cristóbal de La Laguna, Spain
| | | | - Julia Alcoba-Florez
- Servicio de Microbiología, Hospital Universitario N. S. de Candelaria, Santa Cruz de Tenerife, Spain
| | - Rodrigo Trujillo-González
- Laboratorio de Inmunología Celular y Viral, Unidad de Farmacología, Sección de Medicina, Facultad de Ciencias de la Salud, Universidad de La Laguna, San Cristóbal de La Laguna, Spain
- Departamento de Análisis Matemático, Facultad de Ciencias, Universidad de La Laguna, Santa Cruz de Tenerife, Spain
| | | | - Helena Gil-Campesino
- Servicio de Microbiología, Hospital Universitario N. S. de Candelaria, Santa Cruz de Tenerife, Spain
| | - Oscar Díez-Gil
- Servicio de Microbiología, Hospital Universitario N. S. de Candelaria, Santa Cruz de Tenerife, Spain
| | - José M. Lorenzo-Salazar
- Genomics Division, Instituto Tecnológico y de Energías Renovables, Santa Cruz de Tenerife, Spain
| | - Carlos Flores
- Research Unit, Hospital Universitario N. S. de Candelaria, Santa Cruz de Tenerife, Spain
- Genomics Division, Instituto Tecnológico y de Energías Renovables, Santa Cruz de Tenerife, Spain
- CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
- Faculty of Health Sciences, University of Fernando Pessoa Canarias, Las Palmas de Gran Canaria, Spain
| | - Jonay Garcia-Luis
- Laboratorio de Inmunología Celular y Viral, Unidad de Farmacología, Sección de Medicina, Facultad de Ciencias de la Salud, Universidad de La Laguna, San Cristóbal de La Laguna, Spain
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Madureira R, Ferreira SA, Marion MAL, Bettoni F, Ganem F, Camargo AA, Morinaga CV. Seroprevalence of SARS-CoV-2 in Emergency Department Healthcare Workers at Sírio-Libanês Hospital, Brazil. Health Secur 2022; 20:359-367. [PMID: 35960271 DOI: 10.1089/hs.2022.0045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
COVID-19 has spread rapidly worldwide. Information on its prevalence and factors associated with infection are important for protecting both professionals and patients in healthcare centers. This study evaluated the seroprevalence of antibodies against SARS-CoV-2 and its association with the degree of exposure and use of personal protective equipment by healthcare professionals dedicated to the treatment of patients with flu-like illnesses in the emergency room. The research team included an analysis of healthcare professionals who underwent enzyme-linked immunosorbent assay serological testing for SARS-CoV-2 between May 28 and June 26, 2020, in the emergency room of Sírio-Libanês Hospital in São Paulo, Brazil. Participants answered individual questionnaires on occupational information, medical health history, and factors associated with exposure to the novel coronavirus. The questionnaire variables were compared based on the serological results. Of the 164 study participants, 96 (58.54%) reported at least 1 flu-like symptom and 42 (25.61%) presented serology results that were compatible with SARS-CoV-2 infection. The asymptomatic declared group accounted for 62 participants; of these, 8 (12.90%) had positive serology results (neutralizing antibody and IgG) for SARS-CoV-2. Data analysis showed a positive correlation with duration of work, safety in wearing and reusing personal protective equipment, and presence of anosmia, and showed a negative relationship with duration of mask use. Our findings suggest that the perception of symptoms by healthcare professionals is not a good screening parameter for the diagnosis of an infectious disease with respiratory symptoms, such as COVID-19. The main influencing factor for the control of infection is the elaboration of workflows and safety protocols based on simple and clear rules as well as investments in team training.
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Affiliation(s)
- Ricardo Madureira
- Ricardo Madureira, MD, is a Physician, Emergency Department, Hospital Sírio-Libanês, São Paulo, Brazil
| | - Silvia Aparecida Ferreira
- Silvia Aparecida Ferreira, BSN, is a Nurse Care Coordinator, Emergency Department, Hospital Sírio-Libanês, São Paulo, Brazil
| | - Magali Aldrin Lopes Marion
- Magali Aldrin Lopes Marion, BSN, is Nurse Manager, Emergency Department, Hospital Sírio-Libanês, São Paulo, Brazil
| | - Fabiana Bettoni
- Fabiana Bettoni, PhD, is a Researcher, Molecular Oncology Center, Hospital Sírio-Libanês, São Paulo, Brazil
| | - Fernando Ganem
- Fernando Ganem, MD, PhD, is Hospital Director, Hospital Sírio-Libanês, São Paulo, Brazil
| | - Anamaria Aranha Camargo
- Anamaria Aranha Camargo, PhD, is Research Manager, Molecular Oncology Center, Hospital Sírio-Libanês, São Paulo, Brazil
| | - Christian Valle Morinaga
- Christian Valle Morinaga, MD, PhD, is Physician Practice Manager, Emergency Department, Hospital Sírio-Libanês, São Paulo, Brazil
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Langeveld DTJC, Eilers DR, Haverkate MR, Ferreira DJA, de Veer DAJE, Timen A. Nursing care for patients carrying multi-drug resistant organisms: Experiences, intention to use protective equipment and ability to comply with measures. J Clin Nurs 2022. [PMID: 35799380 DOI: 10.1111/jocn.16443] [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: 12/28/2021] [Revised: 03/28/2022] [Accepted: 06/20/2022] [Indexed: 11/30/2022]
Abstract
AIMS The aims of the study were to explore the impact of caring for patients carrying multi-drug resistant organisms on nursing staff and identify factors predicting their intention to use personal protective equipment and their ability to comply with advised infection prevention and control measures. BACKGROUND Carriage of multi-drug resistant organisms and corresponding infection prevention and control measures have a major impact on patients. Limited research has been done to investigate the impact of caring for these patients on nursing staff. DESIGN A cross-sectional design. METHODS Online survey among Dutch nursing staff in various healthcare settings. Prediction analyses were conducted using random forest. The STROBE checklist was used preparing the manuscript. RESULTS 974 respondents were included. The majority of nursing staff reported to have experience in caring for patients carrying multi-drug resistant organisms. Relevant dilemmas in daily practice were identified. Important predictors of the intention to use protective equipment were practicing hand hygiene, usable protocols, favourable attitudes and perceptions, as well as knowledge. Important predictors of the ability to comply with advised measures were usable and findable protocols, a suitable work environment and practicing hand hygiene. CONCLUSION We have gained comprehensive insight into experiences, attitudes, perceptions, knowledge and dilemmas in daily practice of nursing staff caring for patients carrying multi-drug resistant organisms. To enhance their intention to use protective equipment and their ability to comply with advised measures, activities should focus on improving hand hygiene and the usability of protocols. Additionally, efforts are needed to improve knowledge, provide better resources and a more supportive work environment. All of which need to be specifically tailored to each healthcare setting. RELEVANCE TO CLINICAL PRACTICE The results can be used in the development of interventions to improve nursing care while reducing the unfavourable impact on nursing staff and supporting adherence to advised measures.
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Affiliation(s)
- Drs Tessa J C Langeveld
- Dutch Center for infectious Disease Control (LCI), National Institute for Public Health and Environment (RIVM), Bilthoven, The Netherlands.,Athena Institute, Faculty of Science, Vrije Universiteit (VU) Amsterdam, Amsterdam, The Netherlands
| | - Dr Renske Eilers
- Dutch Center for infectious Disease Control (LCI), National Institute for Public Health and Environment (RIVM), Bilthoven, The Netherlands
| | - Manon R Haverkate
- Dutch Center for infectious Disease Control (LCI), National Institute for Public Health and Environment (RIVM), Bilthoven, The Netherlands
| | - Dr José A Ferreira
- Dutch Department of Statistics, Informatics and Modelling, National Institute for Public Health and Environment (RIVM), Bilthoven, The Netherlands
| | - Dr Anke J E de Veer
- Netherlands Institute for Health Services Research (Nivel), Utrecht, The Netherlands
| | - Aura Timen
- Dutch Center for infectious Disease Control (LCI), National Institute for Public Health and Environment (RIVM), Bilthoven, The Netherlands.,Athena Institute, Faculty of Science, Vrije Universiteit (VU) Amsterdam, Amsterdam, The Netherlands
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13
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Waterfield S, Ahmed H, Jones IA, Burky R, Joshi LT. Isolation of Clostridioides difficile PCR Ribotype 027 from single-use hospital gown ties. J Med Microbiol 2022; 71. [PMID: 35675100 DOI: 10.1099/jmm.0.001550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background. Clostridioides difficile is a spore-forming pathogen responsible for antibiotic-associated diarrhoea. In the USA high incidence of C. difficile infection (CDI) in clinical environments has led to interest in C. difficile spore transmission.Hypothesis. Single use hospital surgical gown ties act as a reservoir for C. difficile spores.Aim. This study sought to examine whether single-use hospital surgical gown ties used in surgery, from an acute healthcare facility, harboured C. difficile spores.Methodology. Used surgical gowns ties worn by clinicians in the healthcare facility were examined for C. difficile spore presence via spread plate and anaerobic culture. The colonies isolated from each gown tie were subcultured on C. difficile selective agar for phenotypic confirmation. Presumptive C. difficile colonies were examined using C. difficile Quik Check Complete, 16-23S PCR Ribotyping and MALDI-TOF analysis.Results. In total 17 suspected C. difficile colonies were isolated from 15 gown ties via culture. C. difficile Quik Check Complete found two isolates as possible C. difficile. MALDI-TOF and PCR Ribotyping confirmed one isolate as C. difficile PCR ribotype 027 associated with clinical outbreaks.Discussion. Our study revealed the presence of hypervirulent C. difficile ribotype 027 spores on single-use gown ties. This highlights the potential of gown ties as a vector of spore transmission across clinical environments, especially when gowns are not worn appropriately.Conclusions. Appropriate compliance to infection control procedures by healthcare workers is essential to prevent spore dissemination across clinical facilities and reduce CDI rates.
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Affiliation(s)
- Shannon Waterfield
- School of Biomedical Sciences, Faculty of Health, University of Plymouth, Plymouth, Devon PL4 8AA, UK
| | - Humaira Ahmed
- School of Biomedical Sciences, Faculty of Health, University of Plymouth, Plymouth, Devon PL4 8AA, UK
| | - Imogen Anne Jones
- School of Biomedical Sciences, Faculty of Health, University of Plymouth, Plymouth, Devon PL4 8AA, UK
| | - Robert Burky
- Adventist Health Hospital, Yuba City, California, USA
| | - Lovleen Tina Joshi
- School of Biomedical Sciences, Faculty of Health, University of Plymouth, Plymouth, Devon PL4 8AA, UK
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Personal Protection Equipment and Infection Control Procedures among Health Workers during the COVID-19 Pandemic. Healthcare (Basel) 2022; 10:healthcare10050944. [PMID: 35628080 PMCID: PMC9140658 DOI: 10.3390/healthcare10050944] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/11/2022] [Accepted: 05/16/2022] [Indexed: 02/01/2023] Open
Abstract
Health workers have been particularly affected by the COVID-19 pandemic, but it is unclear which healthcare professions are more exposed. We search for information that can help identify health workers who are employed in exposure-prone professions and who, therefore, routinely wear and adopt strict infection control equipment and measures from other colleagues. Our purpose is to test the hypothesis that health professionals historically considered less exposure-prone are affected more severely by COVID-19. Taking dentists as an example of exposure-prone healthcare professionals, this study aims to analyze data on COVID-19-related deaths reported by the Italian board of doctors and dentists’ database to evaluate the number of COVID-19-related deaths of doctors and dentists in Italy from the beginning of the pandemic to 31 December 2022. As of 31 December 2021, out of 364 deaths, 38 were dentists, and of the remaining 326 doctors, 140 were general practitioners (GPs). The percentage of deaths among dentists, total doctors and GPs results in 0.06%, 0.09% and 0.33%, respectively, for the whole sample. Excluding subjects over 70 years of age, the corresponding values are 0.05%, 0.06% and 0.25%. Most of the deaths occurred in Lombardia, and the geographical distribution overlaps the trend of the corresponding general Italian population. Considering the outcome of “death”, dentists, despite being at high risk, are not particularly affected by COVID-19.
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Biggs AT, Littlejohn LF. A Hierarchy of Medical Countermeasures Against Biological Threats. Mil Med 2022; 187:830-836. [PMID: 35348745 DOI: 10.1093/milmed/usac077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/07/2022] [Accepted: 03/11/2022] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Emerging biological threats represent a serious challenge for force health protection (FHP). Against a novel biological threat, medical countermeasures are the first line of defense. However, as exposed by global pandemic conditions, there are significant complications when administering medical countermeasures against novel threats. One such limitation involved the lack of any guiding structure to discuss and deliberate upon the relative value of employing different countermeasures either alone or in tandem. For example, both personal protective equipment and prophylactic medication can provide some protection, but how are individual protections weighed against operational capabilities and FHP initiatives? The goal of this review is to provide a hierarchical organizing structure to the different medical countermeasures available in response to emerging biological threats. MATERIALS AND METHODS This review used no explicit inclusion or exclusion criteria for its literature review. References are provided for illustrative purposes to represent different components of the medical hierarchy. DISCUSSION The hierarchy presented here is organized around a resource-durability structure that functions as a push-pull mechanism. Specifically, lower levels of the hierarchy require more resources to sustain FHP conditions while also providing less durable protection. These countermeasures require continual reapplication, and so resources become conceived as much in time and effort to apply as in exhaustible supplies. Higher-order countermeasures require less resources investment as a single application can provide weeks, months, or years of protection. Moreover, higher-order protections are less likely to interfere with military operational capabilities, which further support their classification as superior countermeasures to sustain FHP. The five levels of the hierarchy are presented here as follows, organized from lowest to highest value as a medical countermeasure: (1) Sanitization, (2) personal protective equipment, (3) prophylaxis, (4) vaccines, and (5) optimized immune system. Rationale and descriptions identify how each higher-order countermeasure is superior to its lower-order counterparts while noting that optimizing FHP will likely require employing multiple countermeasures at different levels. The discussion concludes with an overview as to how different countermeasures were employed to various degrees during a novel global pandemic. CONCLUSIONS AND FUTURE USES Identifying medical countermeasures is important to optimizing FHP. Different countermeasures have different advantages, and the hierarchy distinguishes between inferior and superior countermeasures through the push-pull style mechanism of resource-durability assessment. Future deployment and development should focus on superior countermeasures to maximize medical protections and operational readiness while understanding the relative value and complications inherent with different countermeasures.
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Affiliation(s)
- Adam T Biggs
- The Force Medical Office, Naval Special Warfare Command, Coronado, CA 92155, USA
| | - Lanny F Littlejohn
- The Force Medical Office, Naval Special Warfare Command, Coronado, CA 92155, USA
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16
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George J, Verma R, Shafqat N. Physiological Hazard Assessment While Wielding Personal Protective Equipment (PPE) Among Health Care Workers. Cureus 2022; 14:e23510. [PMID: 35494999 PMCID: PMC9037050 DOI: 10.7759/cureus.23510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction Accurate use of personal protective equipment (PPE) is an essential part of infection prevention and control measures to protect health care workers and patients from various hazardous conditions. Health care workers caring for patients with potentially infectious health conditions are using PPE for long periods of time. However, long-term use of PPE can cause many physiological health hazards among health care workers. So, the current study was carried out to assess the general health problems and dermatological problems experienced by health care workers with PPE use. Materials and methods A descriptive cross-sectional survey has been carried out in two selected tertiary care hospitals in central India by recruiting 301 health care workers. Non-probability convenient sampling technique was used to select participants for the study. Sociodemographic Performa and structured questionnaires were used to collect data on demographic characteristics of the participants and various health problems experienced by health care workers with PPE use. Collected data were analyzed using appropriate descriptive and inferential statistics. Results The current study reported excessive sweating (86.4%), difficulty in reading (85%), dry mouth (80.7%), and breathing difficulty (74.1%) as the most common problem associated with PPE use. In addition to this, adverse reactions like headache, restlessness, and dizziness were reported by 70.1%, 64.5%, and 50.8%. Indentation and pain on the back of the ears (76.1%), skin soaking (67.1%), and excessive sweating (76.1%) were identified as the most common problems related to N-95 masks, gloves, and coverall use. Conclusion The current study revealed a higher incidence of various health problems with PPE use among health care workers. The findings of the study highlight the importance of developing various guidelines to reduce the negative impact of PPE use and implementing preventive measures to decrease health problems associated with PPE use.
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17
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Bouchoucha SL, Phillips NM, Lucas J, Kilpatrick M, Hutchinson A. An investigation into nursing students' application of infection prevention and control precautions. NURSE EDUCATION TODAY 2021; 104:104987. [PMID: 34098422 DOI: 10.1016/j.nedt.2021.104987] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 05/06/2021] [Accepted: 05/20/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Undergraduate education of Health Care Workers is pivotal to ensuring that frontline clinicians have appropriate knowledge and skills in Infection Prevention and Control (IPC). OBJECTIVES The aim of this study was to describe undergraduate nursing students' self-reported compliance with Standard Precautions and to explore the psychosocial factors that influence adherence in clinical practice. DESIGN A cross-sectional survey design was used. SETTING The study was conducted in the School of Nursing and Midwifery at an Australian University. PARTICIPANTS All undergraduate nursing students were invited to participate in an online survey; 321 participated, mean age 25.7 years (SD = 8.4). The majority, 196 (61%), had no healthcare work experience, 54 (17%) were patient-care assistants, 40 (13%) enrolled nurses, and 31 (9%) were nurses registered overseas. METHODS Two validated instruments were used: the Compliance with Standard Precautions Scale (CSPS) and the Factors Influencing Adherence to Standard Precautions Scale- Student version (FIASPS-SV). Linear regression was used to measure the impact of psychosocial factors on self-reported compliance. RESULTS Overall self-reported compliance with prevention of cross-infection was 83%, use of Personal Protective Equipment (81%), correct disposal of sharps (83%) and general waste (75%), and equipment decontamination (69%). The predominant factors endorsed on the FIASPS-SV were 'Leadership' (M = 15.21 SD = 5.28) and 'Contextual cues' (M = 19.09 SD = 6.37). Multivariate linear regression demonstrated that after adjusting for age, gender and years of nursing study, the Leadership factor predicted participants' self-reported compliance on the 'prevention of cross-infection' (p < .001), 'use of PPE' (p < .001), 'waste disposal' (p = .021), and 'decontamination of equipment' (p < .001) sub-domains of the CSPS. CONCLUSIONS These findings highlight that strong clinical leadership and role modelling are essential to ensure all healthcare students prioritise rigorous adherence with infection prevention and control guidelines.
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Affiliation(s)
- Stéphane L Bouchoucha
- Deakin University Geelong, Australia, School of Nursing and Midwifery, Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Australia.
| | - Nicole M Phillips
- Deakin University Geelong, Australia, School of Nursing and Midwifery, Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Australia
| | - James Lucas
- Deakin University Geelong, Australia, School of Health and Social Development, Australia
| | - Mataya Kilpatrick
- Deakin University Geelong, Australia, School of Nursing and Midwifery, Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Australia
| | - Ana Hutchinson
- Deakin University Geelong, Australia, School of Nursing and Midwifery, Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Australia; Deakin University Geelong, Centre for Quality and Patient Safety Research, Epworth Healthcare Partnership, Australia
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18
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Rodriguez-Lopez M, Parra B, Vergara E, Rey L, Salcedo M, Arturo G, Alarcon L, Holguin J, Osorio L. A case-control study of factors associated with SARS-CoV-2 infection among healthcare workers in Colombia. BMC Infect Dis 2021; 21:878. [PMID: 34452600 PMCID: PMC8391859 DOI: 10.1186/s12879-021-06581-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 08/17/2021] [Indexed: 02/14/2023] Open
Abstract
Background Healthcare Workers (HCW) are repeatedly exposed to SARS-CoV-2 infection. The aim of this study was to identify factors associated with SARS-CoV-2 infection among HCW in one of the largest cities in Colombia. Methods We conducted a case–control study, where cases had a positive reverse transcription-polymerase chain reaction and controls had a negative result. Participants were randomly selected and interviewed by phone. Analyses were performed using logistic regression models. Results A total of 110 cases and 113 controls were included. Men (AdjOR 4.13 95% CI 1.70–10.05), Nurses (AdjOR 11.24 95% CI 1.05–119.63), not using a high-performance filtering mask (AdjOR 2.27 95% CI 1.02–5.05) and inadequate use of personal protective equipment (AdjOR 4.82 95% CI 1.18–19.65) were identified as risk factors. Conversely, graduate (AdjOR 0.06 95% CI 0.01–0.53) and postgraduate (AdjOR 0.05 95% CI 0.005–0.7) education, feeling scared or nervous (AdjOR 0.45 95% CI 0.22–0.91), not always wearing any gloves, caps and goggles/face shields (AdjOR 0.10 95% CI 0.02–0.41), and the use of high-performance filtering or a combination of fabric plus surgical mask (AdjOR 0.27 95% CI 0.09–0.80) outside the workplace were protective factors. Conclusion This study highlights the protection provided by high-performance filtering masks or double masking among HCW. Modifiable and non-modifiable factors and the difficulty of wearing other protective equipment needs to be considered in designing, implementing and monitoring COVID-19 biosafety protocols for HCW.
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Affiliation(s)
- Merida Rodriguez-Lopez
- Pontificia Universidad Javeriana Seccional Cali, Calle 18 No.118 - 250 Edificio Raúl Posada S.J. Tercer Piso, Cali, Colombia.
| | | | - Enrique Vergara
- Pontificia Universidad Javeriana Seccional Cali, Calle 18 No.118 - 250 Edificio Raúl Posada S.J. Tercer Piso, Cali, Colombia
| | - Laura Rey
- Pontificia Universidad Javeriana Seccional Cali, Calle 18 No.118 - 250 Edificio Raúl Posada S.J. Tercer Piso, Cali, Colombia
| | | | - Gabriela Arturo
- Secretaria de Salud Pública Municipal de Cali, Cali, Colombia
| | - Liliana Alarcon
- Secretaria de Salud Pública Municipal de Cali, Cali, Colombia
| | - Jorge Holguin
- Pontificia Universidad Javeriana Seccional Cali, Calle 18 No.118 - 250 Edificio Raúl Posada S.J. Tercer Piso, Cali, Colombia.,Secretaria de Salud Pública Municipal de Cali, Cali, Colombia
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Barratt R, Gilbert GL. Education and training in infection prevention and control: Exploring support for national standards. Infect Dis Health 2021; 26:139-144. [PMID: 33461891 PMCID: PMC7816900 DOI: 10.1016/j.idh.2020.12.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 12/05/2020] [Accepted: 12/06/2020] [Indexed: 11/06/2022]
Abstract
BACKGROUND Effective infection prevention and control (IPC) programmes comprise a hierarchy of preventive measures, one of which is appropriate use of personal protective equipment (PPE). A poor understanding of the role of PPE and sub-optimal use may fail to prevent or even increase pathogen transmission during routine care or an infectious disease outbreak. Variability in delivery and content of IPC and PPE education and training across organisations can lead to confusion, unsafe practice, and lack of confidence among clinicians. In a national survey we explored the perspectives of Australian and New Zealand IPC professionals on the value and feasibility of a national IPC training and monitoring programme to improve and standardise PPE practice and raise the profile of IPC. METHODS A population-based online survey that examined hospital PPE training programmes was distributed to members of three major Australasian organisations representing IPC professionals. Quantitative results of the survey have been reported previously. This paper is a qualitative analysis of responses to two open-ended questions about a national approach to training in IPC and the use of PPE. RESULTS Most respondents agreed that standardising IPC and PPE training could achieve more consistent practice nationally, supported through the provision of educational resources. Including competency in the use of PPE in mandatory IPC standards would assist in improving the practice and raising the profile of IPC more generally. CONCLUSION The results of this study suggest that that there is support for national programmes and standards for use of PPE in Australia and New Zealand.
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Affiliation(s)
- Ruth Barratt
- Centre for Infectious Diseases and Microbiology, Westmead Institute for Medical Research, Westmead, NSW, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, NSW, Australia; The University of Sydney, Westmead Clinical School, Faculty of Medicine and Health, NSW, Australia.
| | - Gwendolyn L Gilbert
- Centre for Infectious Diseases and Microbiology, Westmead Institute for Medical Research, Westmead, NSW, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, NSW, Australia; The University of Sydney, Westmead Clinical School, Faculty of Medicine and Health, NSW, Australia.
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20
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Shenoy ES, Weber DJ. Lessons learned in infection prevention for Ebola virus disease and the coronavirus disease 2019 (COVID-19) pandemic-Principles underlying prevention. Infect Control Hosp Epidemiol 2021; 42:457-460. [PMID: 33427132 PMCID: PMC7870918 DOI: 10.1017/ice.2020.1427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 11/22/2020] [Indexed: 12/25/2022]
Affiliation(s)
- Erica S. Shenoy
- Infection Control Unit, Massachusetts General Hospital, Boston, Massachusetts
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - David J. Weber
- Division of Infectious Disease, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Department of Hospital Epidemiology, UNC Medical Center, Chapel Hill, North Carolina
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21
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Puzniak L, Finelli L, Yu KC, Bauer KA, Moise P, De Anda C, Vankeepuram L, Sepassi A, Gupta V. A multicenter analysis of the clinical microbiology and antimicrobial usage in hospitalized patients in the US with or without COVID-19. BMC Infect Dis 2021; 21:227. [PMID: 33639862 PMCID: PMC7910773 DOI: 10.1186/s12879-021-05877-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 02/03/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Past respiratory viral epidemics suggest that bacterial infections impact clinical outcomes. There is minimal information on potential co-pathogens in patients with coronavirus disease-2019 (COVID-19) in the US. We analyzed pathogens, antimicrobial use, and healthcare utilization in hospitalized US patients with and without severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). METHODS This multicenter retrospective study included patients with > 1 day of inpatient admission and discharge/death between March 1 and May 31, 2020 at 241 US acute care hospitals in the BD Insights Research Database. We assessed microbiological testing data, antimicrobial utilization in admitted patients with ≥24 h of antimicrobial therapy, and length of stay (LOS). RESULTS A total of 141,621 patients were tested for SARS-CoV-2 (17,003 [12.0%] positive) and 449,339 patients were not tested. Most (> 90%) patients tested for SARS-CoV-2 had additional microbiologic testing performed compared with 41.9% of SARS-CoV-2-untested patients. Non-SARS-CoV-2 pathogen rates were 20.9% for SARS-CoV-2-positive patients compared with 21.3 and 27.9% for SARS-CoV-2-negative and -untested patients, respectively. Gram-negative bacteria were the most common pathogens (45.5, 44.1, and 43.5% for SARS-CoV-2-positive, -negative, and -untested patients). SARS-CoV-2-positive patients had higher rates of hospital-onset (versus admission-onset) non-SARS-CoV-2 pathogens compared with SARS-CoV-2-negative or -untested patients (42.4, 22.2, and 19.5%, respectively), more antimicrobial usage (68.0, 45.2, and 25.1% of patients), and longer hospital LOS (mean [standard deviation (SD)] of 8.6 [11.4], 5.1 [8.9], and 4.2 [8.0] days) and intensive care unit (ICU) LOS (mean [SD] of 7.8 [8.5], 3.6 [6.2], and 3.6 [5.9] days). For all groups, the presence of a non-SARS-CoV-2 pathogen was associated with increased hospital LOS (mean [SD] days for patients with versus without a non-SARS-CoV-2 pathogen: 13.7 [15.7] vs 7.3 [9.6] days for SARS-CoV-2-positive patients, 8.2 [11.5] vs 4.3 [7.9] days for SARS-CoV-2-negative patients, and 7.1 [11.0] vs 3.9 [7.4] days for SARS-CoV-2-untested patients). CONCLUSIONS Despite similar rates of non-SARS-CoV-2 pathogens in SARS-CoV-2-positive, -negative, and -untested patients, SARS-CoV-2 was associated with higher rates of hospital-onset infections, greater antimicrobial usage, and extended hospital and ICU LOS. This finding highlights the heavy burden of the COVID-19 pandemic on healthcare systems and suggests possible opportunities for diagnostic and antimicrobial stewardship.
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Affiliation(s)
| | | | - Kalvin C Yu
- Becton, Dickinson and Company, Franklin Lakes, NJ, USA
| | | | | | | | | | | | - Vikas Gupta
- Becton, Dickinson and Company, Franklin Lakes, NJ, USA
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22
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Kwan WM, Mok CK, Kwok YT, Lam HW, Chan KH, Law THS, Leung PM, Mak MY, Que TL, Tang YH. Bundled interventions for consumption management and monitoring of personal protective equipment in COVID-19 pandemic in Hong Kong local hospitals. BMJ Open Qual 2020; 9:bmjoq-2020-000990. [PMID: 33154097 PMCID: PMC7646320 DOI: 10.1136/bmjoq-2020-000990] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 08/21/2020] [Accepted: 10/24/2020] [Indexed: 12/15/2022] Open
Abstract
Since the outbreak of COVID-19 in December 2019, there had been global shortage of personal protective equipment (PPE) supply due to the breakage of supply chain and also the forbidding of PPE exported by various countries. This situation had greatly affected the healthcare services in local hospitals of Hong Kong. To maintain the availability of PPE for healthcare workers in high-risk clinical settings, the cluster management of New Territories West Cluster, Hospital Authority, had implemented a bundle of interventions in controlling and managing the PPE consumption and ensuring its proper use. A Taskforce on Management of PPE was set up in February 2020 with the aim to monitor and manage the use of PPE in five local hospitals and eight general outpatient clinics of New Territories West Cluster, which were governed in a cluster basis, under the COVID-19 epidemic. Interventions including cutting down non-essential services, implementing telecare, monitoring PPE consumption at unit level and PPE stock at the Cluster Central Distribution Centre and forming mobile infection teams were implemented. The updated PPE standards and usage guidelines to clinical staff were promulgated through forums, newsletters and unit visits. The PPE consumption rates of individual unit were reviewed. Significant decrease in PPE consumption rates was noted when comparing with the baseline data. Comparing the data between 20 February and 1 June 2020, the overall PPE consumption rates were reduced by 64% (r=−0.841; p<0.001) while the PPE consumption rates in anaesthesia and operating theatres, and isolation and surveillance wards were reduced by 47% (r=−0.506; p=0.023) and 49% (r=−0.810; p<0.001), respectively. A bundled approach, including both administrative measures and staff education, is effective in managing PPE consumption during major infection outbreaks especially when PPE supply is at risk.
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Affiliation(s)
- Wai-Man Kwan
- Quality and Safety Division, New Territories West Cluster, Hospital Authority, Hong Kong, Hong Kong
| | - Chun-Keung Mok
- Medicine and Geriatrics Department, Tuen Mun Hospital, New Territories West Cluster, Hospital Authority, Hong Kong, Hong Kong
| | - Yick-Ting Kwok
- Quality and Safety Division, New Territories West Cluster, Hospital Authority, Hong Kong, Hong Kong
| | - Hon-Wai Lam
- Administrative Services Division, New Territories West Cluster, Hospital Authority, Hong Kong, Hong Kong
| | - Kwan-Ho Chan
- Administrative Services Division, New Territories West Cluster, Hospital Authority, Hong Kong, Hong Kong
| | - Tat-Hong Samuel Law
- Administrative Services Division, New Territories West Cluster, Hospital Authority, Hong Kong, Hong Kong
| | - Pik-Man Leung
- Nursing Services Division, New Territories West Cluster, Hospital Authority, Hong Kong, Hong Kong
| | - Man-Yu Mak
- Allied Health Departments, New Territories West Cluster, Hospital Authority, Hong Kong, Hong Kong
| | - Tak-Lun Que
- Clinical Pathology Department, New Territories West Cluster, Hospital Authority, Hong Kong, Hong Kong
| | - Yiu-Hang Tang
- Cluster Chief Executive Office, New Territories West Cluster, Hospital Authority, Hong Kong, Hong Kong
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Haggie S, Fitzgerald DA. Pro con debates in clinical medicine infection prevention and control in cystic fibrosis: One size fits all? The argument in favour. Paediatr Respir Rev 2020; 36:97-99. [PMID: 32631758 PMCID: PMC7297174 DOI: 10.1016/j.prrv.2020.06.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 06/09/2020] [Indexed: 12/15/2022]
Abstract
This article advocates for a universal approach to infection control measures in cystic fibrosis. The central tenets of infection control include hand hygiene, contact precautions, regular microbiological surveillance and adopting inpatient, outpatient, domestic and social practices to minimise acquisition of common CF pathogens. Infection control measures should be proactive and prospective, assuming all patients harbour aggressive pathogens, and not relying on past culture results. The challenges of implementing these policies include cost, equipment, education, consistency, meticulousness all whilst balancing additional procedures to a busy clinical workload.
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Affiliation(s)
- S Haggie
- Department of Respiratory Medicine, The Children's Hospital at Westmead, Sydney, NSW, Australia; Discipline of Child & Adolescent Health, Sydney Medical School, Faculty of Health Sciences, University of Sydney, NSW, Australia.
| | - D A Fitzgerald
- Department of Respiratory Medicine, The Children's Hospital at Westmead, Sydney, NSW, Australia; Discipline of Child & Adolescent Health, Sydney Medical School, Faculty of Health Sciences, University of Sydney, NSW, Australia
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24
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Extracorporeal Life Support Organization Coronavirus Disease 2019 Interim Guidelines: A Consensus Document from an International Group of Interdisciplinary Extracorporeal Membrane Oxygenation Providers. ASAIO J 2020; 66:707-721. [PMID: 32604322 PMCID: PMC7228451 DOI: 10.1097/mat.0000000000001193] [Citation(s) in RCA: 249] [Impact Index Per Article: 62.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The Extracorporeal Life Support Organization (ELSO) Coronavirus Disease 2019 (COVID-19) Guidelines have been developed to assist existing extracorporeal membrane oxygenation (ECMO) centers to prepare and plan provision of ECMO during the ongoing pandemic. The recommendations have been put together by a team of interdisciplinary ECMO providers from around the world. Recommendations are based on available evidence, existing best practice guidelines, ethical principles, and expert opinion. This is a living document and will be regularly updated when new information becomes available. ELSO is not liable for the accuracy or completeness of the information in this document. These guidelines are not meant to replace sound clinical judgment or specialist consultation but rather to strengthen provision and clinical management of ECMO specifically, in the context of the COVID-19 pandemic.
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25
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Yeon JH, Shin YS. Effects of Education on the Use of Personal Protective Equipment for Reduction of Contamination: A Randomized Trial. SAGE Open Nurs 2020; 6:2377960820940621. [PMID: 33415295 PMCID: PMC7774400 DOI: 10.1177/2377960820940621] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 06/14/2020] [Indexed: 01/16/2023] Open
Abstract
Introduction Accurate doffing personal protective equipment (PPE) is one of the key practices of infection control because of increased risk of infection transmission caused by medical garments or environmental contamination. Objectives The study aimed to develop a reality-based education program and identify its effects on nurses’ knowledge, attitudes, and contamination after PPE doffing. Methods Randomized control group pretest–posttest design. A total of 56 nurses were randomly assigned to experimental (n = 28) and control (n = 28) groups. The experimental group underwent a new reality-based education program to improve PPE use. Subsequently, participants were assessed on knowledge of and attitude toward PPE use, as well as number and area of contaminated sites after removing PPE and mask fitting test. Results There were no significant differences in knowledge and attitude to PPE use. The experimental group had significantly fewer contaminated sites than the control group (42 vs. 89), and a significantly lower mean contaminated site area (16.63 ± 24.27 vs. 95.41 ± 117.51 cm2). The tuberculosis mask fitting test success rates were 68% and 50% in the experimental and control groups, respectively, but the difference was not significant. Conclusion The reality-based education on use of PPE helps to reduce contamination and improve performance related to the use of PPE for infection control.
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Affiliation(s)
- Jeong Hwa Yeon
- Infection Control Unit, National Health Insurance Service, Ilsan Hospital, Goyang, Republic of Korea.,Graduate School, Hanyang University, Seoul, Republic of Korea
| | - Yong Soon Shin
- School of Nursing, Hanyang University, Seoul, Republic of Korea
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26
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Avo C, Cawthorne KR, Walters J, Healy B. An observational study to identify types of personal protective equipment breaches on inpatient wards. J Hosp Infect 2020; 106:208-210. [PMID: 32590013 PMCID: PMC7311328 DOI: 10.1016/j.jhin.2020.06.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 06/19/2020] [Indexed: 11/22/2022]
Affiliation(s)
- C Avo
- Swansea University Medical School, Institute of Life Science 2, Swansea, UK.
| | - K-R Cawthorne
- Swansea University Medical School, Institute of Life Science 2, Swansea, UK
| | - J Walters
- Infection Prevention and Control, Morriston Hospital, Swansea, UK
| | - B Healy
- Public Health Wales Microbiology, Swansea and Cardiff, UK; Department of Medical Microbiology, Morriston Hospital, Swansea, UK
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27
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Parush A, Wacht O, Gomes R, Frenkel A. Human Factor Considerations in Using Personal Protective Equipment in the COVID-19 Pandemic Context: Binational Survey Study. J Med Internet Res 2020; 22:e19947. [PMID: 32511099 PMCID: PMC7301688 DOI: 10.2196/19947] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 06/02/2020] [Accepted: 06/02/2020] [Indexed: 01/07/2023] Open
Abstract
Background Full level 1 personal protective equipment (PPE) is used in various domains and contexts. Prior research has shown influences of such equipment on performance, comfort, and contamination levels. The coronavirus disease (COVID-19) pandemic forced a pervasive requirement of PPE, with little preparation, rushed deployment, inadequate time for training, and massive use by personnel who are inexperienced or not qualified in its effective use. Objective This study aims to examine the key human factors (physical and ergonomic, perceptual and cognitive) that influence the use of level 1 PPE when attending to patients with suspected or confirmed COVID-19. Methods The research approach consisted of a short survey disseminated to health care professionals in two countries, Israel and Portugal, with similar demographics and health care systems. The survey included 10 items with a 5-point Likert scale regarding the key human factors involved in level 1 PPE, as identified in prior research. Results A total of 722 respondents from Israel and 301 respondents from Portugal were included in the analysis. All the respondents reported using level 1 PPE with patients with COVID-19 in the range of several hours daily to several hours weekly. The Cronbach α was .73 for Israel and .75 for Portugal. Responses showed high levels of difficulty, with medians of 4 for items related to discomfort (n=539/688, 78% in Israel; n=328/377, 87% in Portugal), hearing (n=236/370, 64% in Portugal; n=321/642, 50% in Israel), seeing (n=697/763, 89% in Israel; n=317/376, 84% in Portugal), and doffing (n=290/374, 77% in Portugal; n=315/713, 44% in Israel). A factor analysis showed a set of strongly related variables consisting of hearing, understanding speech, and understanding the situation. This suggests that degradation in communication was strongly associated with degradation in situational awareness. A subsequent mediation analysis showed a direct effect of PPE discomfort on situational awareness (P<.001); this was also influenced (mediated) by difficulties in communicating, namely in hearing and understanding speech. Conclusions In 2020, the COVID-19 pandemic is paving the way for updating PPE design. The use of already deployed technology affords ample opportunities to improve, adapt, and overcome caveats. The findings here suggest that the use of level 1 PPE with patients with COVID-19 has perceptual and cognitive effects, in addition to physical and ergonomic influences. Efforts should be taken to mitigate the harmful effects of such influences, both regarding the performance of medical actions and the risk of contamination to health care workers. Such efforts involve the design of PPE; the introduction of technologies to enhance vision, hearing, and communicating during the use of PPE; and training staff in using the equipment and in effective communication and teamwork protocols.
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Affiliation(s)
- Avi Parush
- Israel Institute of Technology, Haifa, Israel
| | - Oren Wacht
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Ricardo Gomes
- Department of Operational Medicine, Clinical Center of Guarda Nacional Republicana, Lisboa, Portugal
| | - Amit Frenkel
- Intensive Care Unit, Soroka University Medical Center, Beer Sheva, Israel
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