Changes in healthcare workers' knowledge, attitudes, practices, and stress during the COVID-19 pandemic

Knowledge, Attitude, and Practices Regarding Covid-19 Outbreak in Turkey: A Cross-Sectional Study

The COVID-19 infection, which has been increasing all over the world since December 2019 and has experienced its second and third waves in 2020 and 2021, has created fear in the society. Despite the fact that this infection has been fought for about 3 years, it is very important to develop the knowledge, attitudes and skills of the society against disease X (i.e. an unidentified future pandemic) epidemic such as COVID-19 in terms of infection control. The research was cross-sectional in the period that we can call the early days of the pandemic. Data were collected from a total of 312 individuals who attended the Ankara City Hospital Blood Collection Unit between November 1 and November 30, 2020 and accepted participation in the study. The patient information, attitude and behavior form prepared based on the literature information was collected face to face. Chi-square test was applied to determine whether there is a systematic relationship between the categorical variables in the data analysis. Ethics committee permissions and consent from the participants were obtained. According to the results of the study, the knowledge levels of the individuals were half sufficient, they were worried about themselves and their relatives in terms of getting COVID 19, and their attitude toward the COVID-19 pandemic was moderate. As a result, it is necessary to improve the knowledge, attitude and practices of individuals in society to combat the pandemic.

Understanding olfactory dysfunction in the COVID-19 era: insights from a cross-sectional survey of the Saudi community

Background and objectives

COVID-19 has emerged as a public health emergency caused by the coronavirus 2 (SARS-CoV2). However, only a few studies have reported that anosmia is an early predictor of COVID-19. Therefore, this study aimed to assess the current level of knowledge regarding smell dysfunction in COVID-19 era in Saudi community.

Materials and methods

An online survey was conducted using Survey Monkeys in Saudi Arabia. The survey was distributed through Twitter and WhatsApp. The questionnaire included individuals' demographic information, such as sex, age, residence, income, and qualifications, as well as their knowledge of the early symptoms of COVID-19. ANOVA and Mann-Whitney U-test were conducted to analyze the data. There were twelve items on knowledge dimensions which were assessed through five-point Likert scale.

Results

In total, 809 respondents completed the questionnaire. Among them, 658 (81.3%) had no knowledge of how sudden loss of or change in the sense of smell can be the only symptom of COVID-19. However, most participants, 738 (91.2%), knew that fever was a symptom of COVID-19. Similarly, 707 (87.4%) and 772 (95.5%) participants knew that cough and shortness of breath were the major symptoms of COVID-19, respectively. In addition, 395 (48.3%) participants had no information regarding taste changes as a symptom of COVID-19. Notably, participants who were female, married, or diagnosed with COVID-19 had significantly greater knowledge of smell-related issues due to COVID-19 than males, unmarried, and healthy/those without COVID-19.

Conclusion

This study revealed that the Saudi population has an fairly good level of knowledge regarding common COVID-19 symptoms as more than 90% of the participants understood symptoms of COVID-19, but less acceptable knowledge regarding smell and taste dysfunction as more than 80% had no knowledge of change in olfactory and taste function was due to COVID-19.

Adapting Hospital Work During COVID-19 in Quebec (Canada)

Among hospital responses to the COVID19 pandemic worldwide, service reorganization and staff reassignment have been some of the most prominent ways of adapting hospital work to the expected influx of patients. In this article, we examine work reorganization induced by the pandemic by identifying the operational strategies implemented by two hospitals and their staff to contend with the crisis and then analyzing the implications of those strategies. We base our description and analysis on two hospital case studies in Quebec. We used a multiple case study approach, wherein each hospital is considered a unique case. In both cases, work adaptation through staff reassignment was one of the critical measures undertaken to ensure absorption of the influx of patients into the hospitals. Our results showed that this general strategy was designed and applied differently in the two cases. More specifically, the reassignment strategies revealed numerous healthcare resource disparities not only between health territories, but also between different types of facilities within those territories. Comparing the two hospitals' adaptation strategies showed that past reforms in Quebec determined what these reorganizations could achieve, as well as how they would affect workers and the meaning they gave to their work.

COVID-19 Vaccine Acceptance and Hesitancy Among Health Care Workers in Lebanon

BACKGROUND

Lebanon endured its worst economic and financial crisis in 2020-2021. To minimize the impact of COVID-19 pandemic, it is important to improve the overall COVID-19 vaccination rate. Given that vaccine hesitancy among health care workers (HCWs) affects the general population's decision to be vaccinated, our study assessed COVID-19 vaccine acceptance among Lebanon HCWs and identified barriers, demographic differences, and the most trusted sources of COVID-19 information.

METHODS

A cross-sectional study was conducted between January and May 2021 among HCWs across nine hospitals, the Orders of Physicians, Nurses, and Pharmacists in Lebanon. Descriptive statistics were performed to evaluate the COVID-19 vaccine acceptance, and univariate and multivariable to identify their predictors.

RESULTS

Among 879 participants, 762 (86.8%) were willing to receive the COVID-19 vaccine, 52 (5.9%) refused, and 64 (7.3%) were undecided. Males (226/254; 88.9%) and those ≥ 55 years (95/100; 95%) had the highest rates of acceptance. Of the 113 who were not willing to receive the vaccine, 54.9% reported that the vaccine was not studied well enough. Participants with a previous SARS-CoV-2 infection and those who did not know if they had a previous infection (p = 0.002) were less likely to accept the vaccine compared to those with no previous infection. The most trusted COVID-19 sources of information were WHO (69.3%) and healthcare providers (68%).

CONCLUSION

Lebanese HCWs had a relatively high acceptance rate for COVID-19 vaccination compared to other countries. Our findings are important in informing the Lebanese health care authorities to establish programs and interventions to improve vaccine uptake among HCWs and the general population.

Evaluation of Health Care Professionals' Knowledge, Attitudes, and Practice to Prevent the Pandemic Spread of COVID-19: A Questionnaire-Based Cross-Sectional Study from Abha, Saudi Arabia

BACKGROUND

Pharmacists and other healthcare professionals (HCPs) are at risk of transmitting the lethal COVID-19 virus globally and increasing its prevalence.

AIM

The aim of this study was to assess knowledge, attitudes, and practices (KAP) about coronavirus disease 2019 (COVID-19) among HCPs in the Asir region for the first time.

METHODOLOGY

A cross-sectional analysis with 491 healthcare professionals was tested using a pre-tested questionnaire in a tertiary care facility. The association between research variables and questions was determined using Chi-square tests and Kruskal-Wallis tests.

RESULTS

Pharmacists and other HCPs exhibited good knowledge, a positive attitude, and a negative practice pattern regarding COVID-19. There was a strong association between knowledge and attitude (correlation coefficient: 0.17; p < 0.001). However, healthcare practitioners had a suboptimal practice score of 2.09 ± 0.62 regarding COVID-19.

CONCLUSION

This study discovered that despite relatively insufficient practices for adherence to recommended techniques regarding COVID-19 prevention during the outbreak, pharmacists and other healthcare professionals have a high level of awareness and a positive attitude towards COVID-19 as a medical condition. There is a need for more involved HCPs, improved COVID-19 management training, and approaches to make healthcare providers feel less anxious.

Patient safety culture in a COVID-19 ICU compared to a clinical-surgical ICU in the Brazilian Eastern Amazon: A cross-sectional study

BACKGROUND

The COVID-19 pandemic highlighted the need for a new dynamic in the organization and practices of health services, as it required rapid restructuring to promote safe and harm-free assistance.

OBJECTIVE

To assess the dimensions of the patient safety culture (PSC) from the perspective of the health team professionals in clinical-surgical ICU (G1) compared to a COVID-19 ICU (G2).

METHODS

Cross-sectional, analytical, descriptive and inferential study, using the "Hospital Survey on Patient Safety Culture" questionnaire.

RESULTS

The domain "Supervisor/Manager Expectations and Actions Promoting Patient Safety (PS)" was a potential weakness for G1 (p = 0.003). G2 was most positive on improving PS, being informed about errors, considering PS as a top priority to management, and that the units work together to provide the best care (p > 0.05). G1 was most negative about the work culture with staff from other units, exchange of information across units, and shift changes (p > 0.05). The highest PS grade was related to greater communication, and a smaller frequency of events was reported only for G2 (p > 0.05).

CONCLUSION

There must be a balance in terms of attention focused on PS between different ICUs in times of crisis, especially regarding the supervisors/managers actions.

Beta-blockers in post-acute myocardial infarction patients: Drug prescription patterns from 2018 to Italy's first wave of the COVID-19 pandemic

Background: Major guidelines recommend the initiation of a beta-blocker therapy after an acute myocardial infarction (AMI). We aimed to map the treatment pathway of beta-blockers for AMI survivors during the first wave of COVID-19 pandemic in Italy and to investigate predictors for treatment non-initiation. Methods: Healthcare utilization databases of Lombardy Region were investigated. Subjects aged ≥18 years who were hospitalised with AMI in the period February-March-April of 2018, 2019, and 2020 were included, and followed for 30 days from the discharge date, to investigate whether they presented a first prescription of beta-blockers. A multivariate logistic model was performed to evaluate the effect of several covariates on the probability of not receiving a post-AMI beta-blocker therapy. Results: The cohorts comprised 2259, 2383, and 1932 individuals who were hospitalised with AMI in the 3-month period in 2018, 2019, and 2020, respectively. Overall in 2020, about 58-60% of individuals with AMI received a prescription of beta-blockers within 1 month after the discharge. A continuous decreasing trend over time was observed. Men were 30% more likely to start the treatment than women, increasing age was associated with significant increasing probability of not receiving a post-infarction beta-blocker therapy, while having received an antihypertensive or lipid-lowering treatment, or having been hospitalized for heart failure prior to the AMI hospitalization reduced the likelihood of not being treated with beta-blockers. Conclusion: The initiation of beta-blocker treatment after AMI remains an under-prescribed practice, that does not seem to have been further affected by the first wave of the COVID-19 pandemic.

Knowledge, attitude and practice regarding occupational protection against COVID-19 among midwives in China: A nationwide cross-sectional study

Midwives assume the roles in protecting perinatal women and newborns, meanwhile defending their own safety during the epidemic of COVID-19. Since there is currently no specific treatment available that targets the disease, strictly compliance with various infection prevention and control measures appears utmost important to achieve their occupational safety. We then explored the status quo and influencing factors of the knowledge, attitude and practice (KAP) of occupational protection against the COVID-19 among midwives in China. This online cross-sectional survey was conducted on 2663 midwives across the China during the early stages of the pandemic with a self-reported structured questionnaire. 97.4% and 92.9% of them were identified with positive attitude and appropriate practice, respectively, whereas only 6.4% showed good level of knowledge about the occupational protection toward the COVID-19. Midwives with older age, keeping on working during the breakout period, completing the training programs, caring the confirmed COVID-19 cases and having family members with cold-like symptoms were significantly associated with their KAP status. This study could provide valuable information not only for policy makers and administrators to optimize resource allocation and design education programs on targeted midwives, but also serve as a baseline for measuring changes in subsequent, post-intervention KAP studies.

Evaluation of COVID-19 ECHO training program for healthcare workers in India - A Mixed-Method Study

BACKGROUND

The Coronavirus Disease 2019 (COVID-19) has severely challenged healthcare delivery systems worldwide. Healthcare Workers were unable to assess and manage the cases due to limited knowledge of treating the virus and inadequate infrastructure. Digital interventions played a crucial role in the training of healthcare workers to get through the pandemic. Project Extension for Community Healthcare Outcomes (ECHO) initiated the COVID-ECHO telementoring program for strengthening the knowledge and skills of healthcare workers. The study aimed at assessing the effects of the ECHO telementoring model in the capacity building of healthcare workers in the context of COVID-19 in India.

METHOD

We adopted a mixed-method approach with a parallel combination design. A quantitative survey was used to measure changes in the knowledge and self-efficacy among doctors and nurses. In-depth Interviews were used for qualitative exploration of perceptions and experiences of all the study participants. Student t-test and ANOVA were used to assess significant differences between mean scores across participant characteristics for different themes. Statistical significance was set at p < 0.05. In-depth Interviews were analyzed using Framework Analysis. The evaluation followed the first five levels of Moore's model.

RESULTS

The results highlighted the strengthening of knowledge and skills of healthcare workers in the assessment and management of COVID-19 after the ECHO training. Learning and performance ratings were high as 96% reported an increase in knowledge and 98% were able to apply it in their clinical practices. The key challenges identified were technical issues like internet connectivity and lack of interaction due to limited visual connection. The hybrid sessions, use of video camera, feedback mechanism, and inclusion of Continuing Medical Education were recommended by participants to improve the model.

CONCLUSIONS

The findings of this study are an important addition to the pre-existing literature supporting the replicability of the ECHO model in the upskilling of healthcare professionals working in underserved and remote areas, not only in the context of COVID-19 but also in other public health domains. To enhance the effectiveness of this ECHO model, the study findings may be used to refine the model and improve the areas of concern.

Perspective on the challenges of COVID-19 facing healthcare workers

The emergence of COVID-19 has caused a significant impact on healthcare workers (HCWs) across the globe. A few of these challenges include high workload, lack of coordination and direction, changing information, shortage of personal protective equipment (PPE), managing isolation, fear, and increased anxiety, adapting to changes in healthcare practice and policy, coping strategies, and emotional and physical needs. Here, we shed light on some aspects of these challenges among healthcare workers.

SARS-CoV-2 variants and the global pandemic challenged by vaccine uptake during the emergence of the Delta variant: A national survey seeking vaccine hesitancy causes

BACKGROUND

Herd immunity for COVID-19 is the ultimate goal to end the pandemic. Emergence of SARS-CoV-2 variants has been a subject of considerable debate regarding vaccines effectiveness. This ongoing discussion and other evolving variables contribute to the hesitancy toward vaccines and levels of vaccination acceptance among both the healthcare workers and the public. This study was conducted to assess COVID-19 vaccine uptake and hesitancy among the Saudi Arabian population during the emergence of SARS-CoV-2 Delta variant.

METHODS

A national cross-sectional survey conducted between June 28 and July 5, 2021. The survey collected sociodemographic information, personal and family history of previous COVID-19 infection, adherence to precautionary measures, COVID-19 vaccination status, parental willingness to vaccinate their teenage children, and address variable associated with hesitancy to receive vaccination.

RESULTS

Among the 4071 participants, 67 % were women, 86 % of the participants received COVID-19 vaccine, 70 % had very high or high commitment with COVID-19 precautionary measures. On multivariate analysis, vaccine hesitancy was less likely in men (OR 0.652, p-value < 0.001), those who had direct family members infected with COVID-19 (OR 0.455, p-value < 0.001), and those who reported using the Ministry of Health official channels as information sources (OR 0.522, p-value < 0.001), while those younger than 44 years had higher hesitancy to receive the vaccine (1.5-2.1 times). Of the participants, only 42 % showed willingness to vaccinate their teenage (12-18 years old) children.

CONCLUSIONS

The participants in this study had high COVID-19 vaccination rate; however, hesitancy was reported more commonly among women. Their willingness to vaccinate their teenage children was much lower. Participants relying on social media platforms were highly hesitant to receive vaccination. Public health officials should scale up their efforts targeting females, young population, and parents by vaccination awareness campaigns, and refute misinformation spread on social media, especially with the emergence of variants and the news burst that coincide with them.

COVID-19 and Saudi Arabia: Awareness, Attitude, and Practice

The Severe Acute Respiratory Syndrome-CoronaVirus-2 (SARS-CoV-2) pandemic has transformed our appreciation of healthcare awareness worldwide. The amount of related data accumulated during this time has surpassed any other outbreak of a viral pathogen. Healthcare awareness is related to one of the nine pillars of the “World health organization (WHO) operational planning guidelines to support country preparedness and response”. This review is structured around the awareness/knowledge, attitudes, and practices (KAP)-related publications in Saudi Arabia up to date to understand the impact of COVID-19 on these domains. The excellent communication effort response from governments, international, and individuals to keep the public informed about the outbreak is highlighted. Unraveling such impacts on the Saudi communities, including healthcare workers (HCWs)/professionals (HCPs), students, patients with different diseases, and non-professional individuals, is essential in containing the outbreak and planning preventive measures in case of future outbreaks.

SARS-CoV-2 Omicron Variant: Exploring Healthcare Workers' Awareness and Perception of Vaccine Effectiveness: A National Survey During the First Week of WHO Variant Alert

Background

As the SARS-CoV-2 Omicron variant spreads in several countries, healthcare workers' (HCWs) perceptions and worries regarding vaccine effectiveness and boosters warrant reassessment.

Methods

An online questionnaire among HCWs in Saudi Arabia (KSA) was distributed from Dec 1st-6th 2021 to assess their perceptions, vaccine advocacy to the Omicron variant, and their perception of the effectiveness of infection prevention measures and vaccination to prevent its spread, their Omicron variant related worries in comparison to the other variants, and their agreement with mandatory vaccination in general for adults.

Results

Among the 1,285 HCW participants, two-thirds were female, 49.8 % were nurses, 46.4% were physicians, and 50.0% worked in tertiary care hospitals. 66.9% considered vaccination to be the most effective way to prevent the spread of the Omicron variant and future variants. The respondents however perceived social distancing (78.0%), universal masking (77.8%), and avoiding unnecessary travel (71.4%) as slightly superior to vaccination to prevent the spread of SARS-CoV-2 variants. HCWs aging 55 or older agreed significantly with vaccine ineffectiveness to control Omicron spread, while those who believed in non-pharmacological infection prevention measures agreed significantly with vaccination for that purpose. Male HCWs had a significant agreement with mandatory vaccination of all eligible adult populations. On the other hand, unwilling HCWs to receive the vaccine had strong disagreements with mandatory vaccination.

Conclusions

The current study in the first week of Omicron showed that only two-thirds of HCWs felt that vaccination was the best option to prevent the spread of the Omicron variant, indicating the need for further motivation campaigns for vaccination and booster dose. HCWs had a strong belief in infection prevention measures to contain the spread of SARS-CoV-2 variants that should be encouraged and augmented.

The race for a COVID-19 vaccine: where are we up to?

INTRODUCTION

A novel strain of coronavirus, SARS-CoV-2, has triggered a global pandemic of coronavirus disease (COVID-19) in late 2019. In January 2020, the WHO declared this pandemic a public health emergency. This pandemic has already caused over 5.3 million deaths from more than 272 million infections. The development of a successful vaccine is an urgent global priority to halt the spread of SARS-CoV-2 and prevent further fatalities. Researchers are fast-tracking this process, and there have already been significant developments in preclinical and clinical phases in a relatively short period of time. Some vaccines have been approved either for emergency use or mass application in recent months.

AREAS COVERED

Herein, we provide a general understanding of the fast-tracked clinical trial procedures and highlight recent successes in preclinical and clinical trials to generate a clearer picture of the progress of COVID-19 vaccine development.

EXPERT OPINION

A good number of vaccines have been rolled out within a short period a feat unprecedented in medical history. However, the emergence of new variants over time has appeared as a new threat, and the number of infections and casualties is still on the rise and this is going to be an ongoing battle.

Psychological Distress and Anxiety Levels Among Health Care Workers at the Height of the COVID-19 Pandemic in the United Arab Emirates

Objectives: Providing medical care during a global pandemic exposes healthcare workers (HCW) to a high level of risk, causing anxiety and stress. This study aimed to assess the prevalence of anxiety and psychological distress among HCWs during COVID-19. Methods: We invited HCWs from 3 hospitals across the United Arab Emirates (UAE) to participate in an anonymous online survey between April 19-May 3, 2020. The GAD-7 and K10 measures were used to assess anxiety and psychological distress. Logistic regression models assessed associations between knowledge, attitude, worry, and levels of anxiety and psychological distress. Results: A total of 481 HCWs participated in this study. The majority of HCWs were female (73.6%) and aged 25-34 years (52.6%). More than half were nurses (55.7%) and had good knowledge of COVID-19 (86.3%). Over a third (37%) of HCWs reported moderate/severe psychological distress in the K10 measure and moderate/severe anxiety (32.3%) in the GAD-7, with frontline workers significantly reporting higher levels of anxiety (36%). Knowledge of COVID-19 did not predict anxiety and psychological distress, however, HCWs who believed COVID-19 was difficult to treat and those who perceived they were at high risk of infection had worse mental health outcomes. Worry about spreading COVID-19 to family, being isolated, contracting COVID-19 and feeling stigmatized had 1.8- to 2.5-fold increased odds of symptoms of mental health problems. Additionally, HCWs who felt the need for psychological support through their workplace showed increased odds of psychological distress. Conclusion: HCWs in the UAE reported a high prevalence of psychological distress and anxiety while responding to the challenges of COVID-19. The findings from this study emphasize the public, emotional and mental health burden of COVID-19 and highlight the importance for health systems to implement, monitor, and update preventive policies to protect HCWs from contracting the virus while also providing psychological support in the workplace.

Stress and Burnout Related to Electronic Health Record Use among Healthcare Providers during the COVID-19 Pandemic in Saudi Arabia: A Preliminary National Randomized Survey

Healthcare providers' burnout may potentially have a negative impact on patient care. The use of the electronic health record (EHR) increases the burden for healthcare providers (HCPs), particularly during the coronavirus disease-2019 (COVID-19) pandemic. This study assessed the stress and burnout related to the use of EHRs and health information technology (HIT) tools among HCPs during COVID-19 in Saudi Arabia. We used a self-developed survey tool. It consisted of five sections; demographics and professional data, experience using EHR, effects of EHR use, use of EHR and technology tools during COVID-19, and health and wellbeing. The survey link was emailed to a random sample of HCPs registered with a national scientific regulatory body. Univariate, bivariate, and multivariate analyses were performed to measure the association between burnout and study variables. A total of 182 participants completed the survey. 50.5% of participants reported a presence of HIT-related stress, and 40.1% reported a presence of burnout. The variables independently associated with burnout were providing tertiary level of care, working with COVID-19 suspected cases, dissatisfaction with EHRs, and agreement with the statement that using EHRs added frustration to the workday. Further research that explores possible solutions is warranted to minimize burnout among HCPs, especially during infectious outbreaks.

COVID-19 vaccine uptake among healthcare workers in the fourth country to authorize BNT162b2 during the first month of rollout

BACKGROUND

The Kingdom of Saudi Arabia (KSA) was the fourth country in the world to authorize the BNT162b2 coronavirus disease 2019 (COVID-19) vaccine, which it rolled out on December 17, 2020 and first targeted at healthcare workers (HCWs). This study assesses vaccine uptake among this group during the first month of its availability.

METHODS

A national cross-sectional, pilot-validated, self-administered survey was conducted among HCWs in the KSA between December 27, 2020 and January 3, 2021. The survey included sociodemographic details, previous contact with COVID-19 patients, previous infection with COVID-19, receiving (or registering with the Ministry of Health website to receive) the COVID-19 vaccine, sources of HCWs' information on vaccines, awareness of emerging variants of concern, and anxiety level using the 7-item Generalized Anxiety Disorder assessment. A descriptive bivariate analysis and multivariate logistic binary regression analysis were performed. The primary evaluated outcome was vaccine uptake.

RESULTS

Of the 1058 participants who completed the survey, 704 (66.5%) were female, and 626 (59.2%) were nurses. Of all the respondents, 352 (33.27%) were enrolled to receive or had already received the vaccine, while 706 (66.73%) had not enrolled. In a bivariate analysis, not enrolling for vaccination was more likely in females than males (78.5% vs. 21.5%, P < 0.001), HCWs between the ages of 20 and 40 years than those >40 years (70.4% vs. 29.6%, P = 0.005), Saudi HCWs than expatriates (78% vs 22%, P < 0.001), and among HCWs who used social media as a source of information than those who did not (69.8% vs. 38.6%, P < 0.001). In a multivariate analysis, independent factors associated with uptake were being a Saudi national (aOR = 1.918, 95 %CI = 1.363-2.698, P < 0.001), working in an intensive care unit (aOR = 1.495, 95 %CI = 1.083-2.063, P = 0.014), and working at a university hospital (aOR = 1.867, 95 %CI = 1.380-2.525, P < 0.001).

CONCLUSIONS

A low level of vaccine uptake was observed especially in female HCWs, those younger than 40 years old, and those who used social media as their source of vaccine information. This survey provides important information for public health authorities in order to scale up vaccination campaigns targeting these HCWs to increase vaccine enrollment and uptake.

COVID-19 Critical Care Simulations: An International Cross-Sectional Survey

Objective: To describe the utility and patterns of COVID-19 simulation scenarios across different international healthcare centers. Methods: This is a cross-sectional, international survey for multiple simulation centers team members, including team-leaders and healthcare workers (HCWs), based on each center's debriefing reports from 30 countries in all WHO regions. The main outcome measures were the COVID-19 simulations characteristics, facilitators, obstacles, and challenges encountered during the simulation sessions. Results: Invitation was sent to 343 simulation team leaders and multidisciplinary HCWs who responded; 121 completed the survey. The frequency of simulation sessions was monthly (27.1%), weekly (24.8%), twice weekly (19.8%), or daily (21.5%). Regarding the themes of the simulation sessions, they were COVID-19 patient arrival to ER (69.4%), COVID-19 patient intubation due to respiratory failure (66.1%), COVID-19 patient requiring CPR (53.7%), COVID-19 transport inside the hospital (53.7%), COVID-19 elective intubation in OR (37.2%), or Delivery of COVID-19 mother and neonatal care (19%). Among participants, 55.6% reported the team's full engagement in the simulation sessions. The average session length was 30-60 min. The debriefing process was conducted by the ICU facilitator in (51%) of the sessions followed by simulation staff in 41% of the sessions. A total of 80% reported significant improvement in clinical preparedness after simulation sessions, and 70% were satisfied with the COVID-19 sessions. Most perceived issues reported were related to infection control measures, followed by team dynamics, logistics, and patient transport issues. Conclusion: Simulation centers team leaders and HCWs reported positive feedback on COVID-19 simulation sessions with multidisciplinary personnel involvement. These drills are a valuable tool for rehearsing safe dynamics on the frontline of COVID-19. More research on COVID-19 simulation outcomes is warranted; to explore variable factors for each country and healthcare system.

Virtual Handover of Patients in the Pediatric Intensive Care Unit During the Covid-19 Crisis

OBJECTIVE

A key measure to mitigate coronavirus disease 2019 (COVID-19) has been social distancing. Incorporating video-conferencing applications in the patient handover process between healthcare workers can enhance social distancing while maintaining handover elements. This study describes pediatric intensive care unit (PICU) physicians' experience using an online video-conferencing application for handover during the COVID-19 pandemic.

DESIGN

Qualitative content analysis.

SETTING

PICU at a university hospital in Riyadh, Saudi Arabia.

SUBJECTS

PICU Physicians.

INTERVENTIONS

Due to the pandemic, the hospital's PICU used Zoom® as a remote conferencing application instead of a face-to-face handover. Following institutional review board approval, data were collected over two weeks (1 Jul 2020 to 14 Jul 2020).

MEASUREMENTS

An online survey was conducted using open-ended questions to capture demographic data and the perceived efficacy of remote handovers. Thematic framework analysis process included open coding, creating categories, and abstraction.

MAIN RESULTS

All 37 PICU physicians who participated in the handover completed the survey. The participants comprised six attendings, nine specialists, and 22 residents. While 20 (54.1%) physicians reported attending 1-5 Zoom handovers by the time of the study, some (n. 6, 16.2%) had more than ten virtual handovers. They had variable previous teleconferencing experiences. Most physicians (78.4%) were comfortable conducting a remote handover. Most found that Situation-Background-Assessment-Recommendation handover elements were properly achieved through this remote handover process. The perceived advantages of online handover included fewer interruptions, time efficiency, and facilitation of social distancing. The perceived disadvantages were the paucity of nonverbal communication and teaching during virtual meetings.

CONCLUSION

Video-conferencing applications for online handovers could supplement traditional face-to-face intensive care unit patient handover during outbreaks of infectious diseases. The use of video streaming and more emphasis on teaching should be encouraged to optimize the users' experience.

SARS-CoV-2 B.1.1.7 UK Variant of Concern Lineage-Related Perceptions, COVID-19 Vaccine Acceptance and Travel Worry Among Healthcare Workers

Background: Healthcare workers' (HCWs') travel-related anxiety needs to be assessed in light of the emergence of SARS-CoV-2 mutations. Methods: An online, cross-sectional questionnaire among HCWs between December 21, 2020 to January 7, 2021. The outcome variables were HCWs' knowledge and awareness of the SARS-CoV-2 B.1.1.7 lineage that was recently reported as the UK variant of concern, and its associated travel worry and Generalized Anxiety Disorder (GAD-7) score. Results: A total of 1,058 HCWs completed the survey; 66.5% were female, 59.0% were nurses. 9.0% indicated they had been previously diagnosed with COVID-19. Regarding the B.1.1.7 lineage, almost all (97.3%) were aware of its emergence, 73.8% were aware that it is more infectious, 78.0% thought it causes more severe disease, and only 50.0% knew that current COVID-19 vaccines are effective in preventing it. Despite this, 66.7% of HCWs were not registered to receive the vaccine. HCWs' most common source of information about the new variant was social media platforms (67.0%), and this subgroup was significantly more worried about traveling. Nurses were more worried than physicians (P = 0.001). Conclusions: Most HCWs were aware of the emergence of the SARS-CoV-2 B.1.1.7 variant and expressed substantial travel worries. Increased worry levels were found among HCWs who used social media as their main source of information, those with lower levels of COVID-19 vaccine uptake, and those with higher GAD-7 scores. The utilization of official social media platforms could improve accurate information dissemination among HCWs regarding the Pandemic's evolving mutations. Targeted vaccine campaigns are warranted to assure HCWs about the efficacy of COVID-19 vaccines toward SARS-CoV-2 variants.