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Kim E, Park Y, Choi H. Factors influencing nurses' compliance related to the use of personal protective equipment during the COVID-19 pandemic: A descriptive cross-sectional study. Nurs Open 2024; 11:e2235. [PMID: 38958036 PMCID: PMC11220485 DOI: 10.1002/nop2.2235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 06/11/2024] [Accepted: 06/21/2024] [Indexed: 07/04/2024] Open
Abstract
AIM To determine how nurses' experiences with the coronavirus disease (COVID-19) pandemic affected their knowledge, awareness, and compliance related to the use of personal protective equipment (PPE) during the COVID-19 pandemic in South Korea. DESIGN A descriptive cross-sectional study. METHODS A total of 247 nurses in South Korea participated in this study between May 10 and 19, 2023. An online self-report questionnaire was used to collect data on demographic and occupational characteristics, COVID-19 experience, knowledge, awareness, and compliance related to the use of PPE. Factors affecting compliance were analysed using hierarchical multiple linear regression. RESULTS Mean age of the nurses was 31.92, and 94.3% were women. Most had a bachelor's degree or higher and the mean clinical experience as a nurse was 6.45 years. Knowledge of the use of PPE was 8.45 out of 10, awareness was 3.52 out of 5, and compliance was 4.28 out of 5. Knowledge and awareness were correlated with compliance related to PPE use. Awareness (β = 0.234, p < 0.001), knowledge (β = 0.218, p < 0.001), experience caring for COVID-19 patients (β = 0.234, p = 0.004), optional fourth dose vaccine (β = 0.150, p = 0.017), clinical experience (β = 0.140, p = 0.022), and COVID-19 infection control education (β = 0.115, p = 0.037) were found to have a significant impact on compliance. CONCLUSION During the COVID-19 pandemic, nurses' knowledge and awareness of PPE use was a crucial factor in compliance. factors such as clinical experience, experience in caring for COVID-19 patients, optional vaccination, and completion of COVID-19 education also influenced compliance. We hope that these factors can provide a basis for developing training programs for nurses to respond to future emerging infectious diseases.
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Affiliation(s)
- Eun‐Jin Kim
- Department of NursingSeoul National University HospitalSeoulRepublic of Korea
| | - Yeon‐Hwan Park
- College of Nursing, The Research Institute of Nursing ScienceSeoul National UniversitySeoulRepublic of Korea
| | - Hye‐Ran Choi
- Department of Clinical NursingUniversity of UlsanSeoulRepublic of Korea
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Boroumand S, Majidi RF, Gheibi A, Majidi RF. Selenium nanoparticles incorporated in nanofibers media eliminate H1N1 activity: a novel approach for virucidal antiviral and antibacterial respiratory mask. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024; 31:2360-2376. [PMID: 38063966 DOI: 10.1007/s11356-023-31202-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 11/20/2023] [Indexed: 01/18/2024]
Abstract
The consecutive viral infectious outbreaks impose severe complications on public health besides the economic burden which led to great interest in antiviral personal protective equipment (PPE). Nanofiber-based respiratory mask has been introduced as a significant barrier to eliminate the airborne transmission from aerosols toward reduction the viral infection spreading. Herein, selenium nanoparticles incorporated in polyamide 6 nanofibers coated on spunbond nonwoven were synthesized via electrospinning technique (PA6@SeNPs), with an average diameter of 180 ± 2 nm. The nanofiber-coated media were tested for 0.3 μm particulate filtration efficiency based on Standard NIOSH (42 CFR 84). PA6@SeNPs had a pressure drop of 45 ± 2 Pa and particulate filtration efficiency of more than 97.33 which is comparable to the N95 respiratory mask. The bacterial killing efficiency of these nanofibers was 91.25% and 16.67% against Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli), respectively. Furthermore, the virucidal antiviral test for H1N1 infected Madin-Darby Canine Kidney cells (MDCK) exhibited TCID50 of 108.13, 105.88, and 105.5 for 2, 10, and 120 min of exposure times in comparison with 108.5, 107.5, and 106.5 in PA6 nanofibers as control sample. MTT assay indicated excellent biocompatibility of electrospun PA6@SeNP nanofibers on L292 cells. These results propose the PA6@SeNP nanofibers have a high potential to be used as an efficient layer in respiratory masks for protection against respiratory pathogens.
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Affiliation(s)
| | | | - Ali Gheibi
- Fanavaran Nano-Meghyas (Fnm Co. Ltd.), Tehran, Iran
| | - Reza Faridi Majidi
- Fanavaran Nano-Meghyas (Fnm Co. Ltd.), Tehran, Iran.
- Department of Medical Nanotechnology, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran.
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Sunkwa-Mills G, Senah K, Breinholdt M, Aberese-Ako M, Tersbøl BP. A qualitative study of infection prevention and control practices in the maternal units of two Ghanaian hospitals. Antimicrob Resist Infect Control 2023; 12:125. [PMID: 37953285 PMCID: PMC10641978 DOI: 10.1186/s13756-023-01330-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 11/03/2023] [Indexed: 11/14/2023] Open
Abstract
INTRODUCTION Healthcare-associated infections (HAIs) remain a common challenge in healthcare delivery, with a significant burden in low- and middle-income countries. Preventing HAIs has gained enormous attention from policy makers and healthcare managers and providers, especially in resource-limited settings. Despite policies to enforce infection prevention and control (IPC) measures to prevent HAIs, IPC compliance remains a challenge in hospital settings. In this study, we explore the experiences of healthcare providers and women in the post-natal phase and investigate factors influencing IPC practices in two hospitals in Ghana. METHODS The study used a qualitative approach involving semi-structured interviews, focus group discussions, and observations among healthcare providers and women in the postnatal phase in two maternity units from January 2019 to June 2019. Interviews were recorded and transcribed verbatim for thematic analysis. The data sets were uploaded into the qualitative software NVivo 12 to facilitate coding and analysis. FINDINGS Healthcare providers were driven by the responsibility to provide medical care for their patients and at the same time, protect themselves from infections. IPC facilitators include leadership commitment and support, IPC training and education. Women were informed about IPC in educational talks during antenatal care visits, and their practices were also shaped by their background and their communities. IPC barriers include the poor documentation or 'invisibility' of HAIs, low prioritization of IPC tasks, lack of clear IPC goals and resources, discretionary use of guidelines, and communication-related challenges. The findings demonstrate the need for relevant power holders to position themselves as key drivers of IPC and develop clear goals for IPC. Hospital managers need to take up the responsibility of providing the needed resources and leadership support to facilitate IPC. Patient engagement should be more strategic both within the hospital and at the community level.
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Affiliation(s)
- Gifty Sunkwa-Mills
- Ghana Health Service, Awutu Senya East Municipal, Kasoa, Central Region, Ghana.
- Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Kodjo Senah
- Department of Sociology, University of Ghana, Legon, Accra, Ghana
| | | | - Matilda Aberese-Ako
- Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
| | - Britt Pinkowski Tersbøl
- Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Tsandila-Kalakou F, Wiig S, Aase K. Factors contributing to healthcare professionals' adaptive capacity with hospital standardization: a scoping review. BMC Health Serv Res 2023; 23:799. [PMID: 37496014 PMCID: PMC10369840 DOI: 10.1186/s12913-023-09698-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 06/13/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND Certain factors contribute to healthcare professionals' adaptive capacities towards risks, challenges, and changes such as attitudes, stress, motivation, cognitive capacity, group norms, and teamwork. However, there is limited evidence as to factors that contribute to healthcare professionals' adaptive capacity towards hospital standardization. This scoping review aimed to identify and map the factors contributing to healthcare professionals' adaptive capacity with hospital standardization. METHODS Scoping review methodology was used. We searched six academic databases to September 2021 for peer-reviewed articles in English. We also reviewed grey literature sources and the reference lists of included studies. Quantitative and qualitative studies were included if they focused on factors influencing how healthcare professionals adapted towards hospital standardization such as guidelines, procedures, and strategies linked to clinical practice. Two researchers conducted a three-stage screening process and extracted data on study characteristics, hospital standardization practices and factors contributing to healthcare professionals' adaptive capacity. Study quality was not assessed. RESULTS A total of 57 studies were included. Factors contributing to healthcare professionals' adaptive capacity were identified in numerous standardization practices ranging from hand hygiene and personal protective equipment to clinical guidelines or protocols on for example asthma, pneumonia, antimicrobial prophylaxis, or cancer. The factors were grouped in eight categories: (1) psychological and emotional, (2) cognitive, (3) motivational, (4) knowledge and experience, (5) professional role, (6) risk management, (7) patient and family, and (8) work relationships. This combination of individual and group/social factors decided whether healthcare professionals complied with or adapted hospital standardization efforts. Contextual factors were identified related to guideline system, cultural norms, leadership support, physical environment, time, and workload. CONCLUSION The literature on healthcare professionals' adaptive capacity towards hospital standardization is varied and reflect different reasons for compliance or non-compliance to rules, guidelines, and protocols. The knowledge of individual and group/social factors and the role of contextual factors should be used by hospitals to improve standardization practices through educational efforts, individualised training and motivational support. The influence of patient and family factors on healthcare professionals' adaptive capacity should be investigated. TRIAL REGISTRATION Open Science Framework ( https://osf.io/ev7az ) https://doi.org/10.17605/OSF.IO/EV7AZ .
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Affiliation(s)
- Foteini Tsandila-Kalakou
- Centre for Resilience in Healthcare SHARE, Faculty of Health Sciences, University of Stavanger, N-4036, Stavanger, Norway.
| | - Siri Wiig
- Centre for Resilience in Healthcare SHARE, Faculty of Health Sciences, University of Stavanger, N-4036, Stavanger, Norway
| | - Karina Aase
- Centre for Resilience in Healthcare SHARE, Faculty of Health Sciences, University of Stavanger, N-4036, Stavanger, Norway
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George J, Shafqat N, Verma R, Patidar AB. Factors Influencing Compliance With Personal Protective Equipment (PPE) Use Among Healthcare Workers. Cureus 2023; 15:e35269. [PMID: 36968930 PMCID: PMC10035759 DOI: 10.7759/cureus.35269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2023] [Indexed: 02/23/2023] Open
Abstract
Introduction Accurate and appropriate use of personal protective equipment (PPE) is an integral component in infection prevention and control policy to ensure healthcare workers' safety. Poor compliance with personal protective behaviours and inconsistent use of PPE has been identified as the main cause of transmission of nosocomial infections in healthcare settings and this reduced compliance is linked to many individual, environmental, and organizational factors. Therefore, the current study was carried out to identify various factors influencing PPE use among healthcare workers. Materials and methods A descriptive cross-sectional survey has been carried out among healthcare workers selected from two selected tertiary care hospitals in central India. Data on compliance with PPE and factors influencing compliance were collected using a three-point rating scale and structured questionnaire. Quantile regression was performed to identify the factors associated with adherence to PPE use among healthcare workers. Results The median score for compliance with PPE use among healthcare workers was found to be 22 with an interquartile range (IQR) of 16-24. The multiple quantile regression found that variables such as occupation (p<0.001), institutional policy (p=0.003), quality of PPE (p=0.002), availability of PPE (p<0.001), and improper size (p=0.042) were significantly associated with PPE compliance by healthcare workers. Conclusion The current study highlights the importance of taking adequate measures by the government and healthcare organizations to eliminate various factors hindering PPE compliance levels among healthcare workers to ensure consistent use of PPE by healthcare workers to safeguard themselves and patients.
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Wolffe TAM, Turrell L, Robinson A, Dickens K, Clinton A, Maritan-Thomson D, Stec AA. Culture and awareness of occupational health risks amongst UK firefighters. Sci Rep 2023; 13:97. [PMID: 36627294 PMCID: PMC9832120 DOI: 10.1038/s41598-022-24845-8] [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: 07/29/2022] [Accepted: 11/21/2022] [Indexed: 01/12/2023] Open
Abstract
Firefighters are exposed to toxic chemicals not only from the fire incidents they attend, but also from their contaminated station and/or personal protective equipment (PPE). Little is currently known about firefighters' awareness, attitudes, and behaviours towards contaminants which was assessed in the UK firefighter contamination survey. Results revealed that lack of training on fire effluents and their health outcomes are strongly associated with increased fire smoke/contaminant exposure. Notably, untrained firefighters were at least twice as likely to: never clean personal protective equipment (PPE) (Crude Odds Ratio, OR 2.0, 1.5-2.7), infrequently send their PPE for professional cleaning (OR 2.0, 1.6-2.4), remain in the workwear (t-shirt etc.) worn while attending a fire incident (OR up to 3.6, 2.3-5.6), and indicate that cleaning at fire stations is not taken seriously (OR 2.4, 2.2-2.6). Firefighters personally viewing contamination as a "badge of honour" (BoH) were at least twice as likely to: remain in contaminated PPE after fire incidents (OR 2.3, 1.4-3.9), eat with sooty hands (OR 2.2, 1.9-2.5), notice soot in the nose/throat (OR 3.7, 2.7-5.2), and smell fire smoke on the body for more than a day after incidents (OR 2.0, 1.6-2.4). They were also more likely to indicate that cleaning at fire stations is not taken seriously (OR 2.5, 2.2-2.9) and that fire stations smell of smoke always/most of the time (OR 2.3, 2.0-2.6). Strong links were also found between belief in the BoH and never cleaning PPE (OR 1.9, 1.4-2.7), and eating while wearing contaminated PPE (OR 1.8, 1.5-2.2).
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Affiliation(s)
- Taylor A. M. Wolffe
- grid.7943.90000 0001 2167 3843Centre for Fire and Hazards Sciences, University of Central Lancashire, Preston, Lancashire PR1 2HE UK
| | - Louis Turrell
- grid.7943.90000 0001 2167 3843Centre for Fire and Hazards Sciences, University of Central Lancashire, Preston, Lancashire PR1 2HE UK ,grid.440181.80000 0004 0456 4815Royal Preston Hospital, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, Lancashire PR2 9HT UK
| | - Andrew Robinson
- grid.7943.90000 0001 2167 3843Centre for Fire and Hazards Sciences, University of Central Lancashire, Preston, Lancashire PR1 2HE UK ,grid.440181.80000 0004 0456 4815Royal Preston Hospital, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, Lancashire PR2 9HT UK
| | - Kathryn Dickens
- grid.7943.90000 0001 2167 3843Centre for Fire and Hazards Sciences, University of Central Lancashire, Preston, Lancashire PR1 2HE UK
| | - Anna Clinton
- grid.7943.90000 0001 2167 3843Centre for Fire and Hazards Sciences, University of Central Lancashire, Preston, Lancashire PR1 2HE UK
| | - Daniella Maritan-Thomson
- grid.7943.90000 0001 2167 3843Centre for Fire and Hazards Sciences, University of Central Lancashire, Preston, Lancashire PR1 2HE UK
| | - Anna A. Stec
- grid.7943.90000 0001 2167 3843Centre for Fire and Hazards Sciences, University of Central Lancashire, Preston, Lancashire PR1 2HE UK
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Wolffe TAM, Robinson A, Dickens K, Turrell L, Clinton A, Maritan-Thomson D, Joshi M, Stec AA. Cancer incidence amongst UK firefighters. Sci Rep 2023; 12:22072. [PMID: 36627291 PMCID: PMC9831995 DOI: 10.1038/s41598-022-24410-3] [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: 07/29/2022] [Accepted: 11/15/2022] [Indexed: 01/12/2023] Open
Abstract
Firefighters suffer an increased risk of cancer from exposures to chemicals released from fires. Our earlier research has found that fire toxicants not only remain on firefighters' PPE, but are also tracked back to fire stations. The UK Firefighter Contamination Survey assesses firefighters' risk of developing cancer due to occupational exposure to fire toxins. Over 4% of surveyed firefighters were found to have a cancer diagnosis, with the age-specific cancer rate up to 323% higher (35-39 year olds) than that of the general population. Firefighters who had served ≥ 15 years were 1.7 times more likely to develop cancer than those who had served less time. Firefighters were at least twice as likely to be diagnosed with cancer if they noticed soot in their nose/throat (odds ratio (OR) = 2.0, 1.1-3.5), or remained in their PPE for more than four hours after attending a fire incident (OR = 2.3, 1.1-5.2). Also associated with an increased likelihood of cancer was: eating while wearing PPE (OR = 1.8, 1.2-2.7); failing to store clean/dirty PPE separately (OR = 1.3, 1.0-1.7); working in a station that smells of fire (OR = 1.3, 1.0-1.8) or not having designated (separated) clean and dirty areas (OR = 1.4, 1.1-1.7); using an on-site washing machine to launder fire hoods (OR = 1.3, 1.0-1.7); feeling that cleaning is not taken seriously at work (OR = 1.5, 1.2-2.0).
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Affiliation(s)
- Taylor A. M. Wolffe
- grid.7943.90000 0001 2167 3843Centre for Fire and Hazards Sciences, University of Central Lancashire, Preston, Lancashire, PR1 2HE UK
| | - Andrew Robinson
- grid.7943.90000 0001 2167 3843Centre for Fire and Hazards Sciences, University of Central Lancashire, Preston, Lancashire, PR1 2HE UK ,grid.416204.50000 0004 0391 9602Royal Preston Hospital, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, Lancashire, PR2 9HT UK
| | - Kathryn Dickens
- grid.7943.90000 0001 2167 3843Centre for Fire and Hazards Sciences, University of Central Lancashire, Preston, Lancashire, PR1 2HE UK
| | - Louis Turrell
- grid.7943.90000 0001 2167 3843Centre for Fire and Hazards Sciences, University of Central Lancashire, Preston, Lancashire, PR1 2HE UK ,grid.416204.50000 0004 0391 9602Royal Preston Hospital, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, Lancashire, PR2 9HT UK
| | - Anna Clinton
- grid.7943.90000 0001 2167 3843Centre for Fire and Hazards Sciences, University of Central Lancashire, Preston, Lancashire, PR1 2HE UK
| | - Daniella Maritan-Thomson
- grid.7943.90000 0001 2167 3843Centre for Fire and Hazards Sciences, University of Central Lancashire, Preston, Lancashire, PR1 2HE UK
| | - Miland Joshi
- grid.7943.90000 0001 2167 3843Lancashire Clinical Trials Unit, University of Central Lancashire, Preston, Lancashire, PR1 2HE UK
| | - Anna A. Stec
- grid.7943.90000 0001 2167 3843Centre for Fire and Hazards Sciences, University of Central Lancashire, Preston, Lancashire, PR1 2HE UK
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King EC, Zagrodney KAP, McKay SM, Holness DL, Nichol KA. Determinants of nurse's and personal support worker's adherence to facial protective equipment in a community setting during the COVID-19 pandemic in Ontario, Canada: A pilot study. Am J Infect Control 2022; 51:490-497. [PMID: 35917934 PMCID: PMC9338445 DOI: 10.1016/j.ajic.2022.07.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 07/18/2022] [Accepted: 07/20/2022] [Indexed: 12/05/2022]
Abstract
Background Appropriate and consistent facial protective equipment (FPE) use is critical for preventing respiratory illness transmission. Little is known about FPE adherence by home care providers. The purpose of this study is to adapt an existing facial protection questionnaire and use it to develop an initial understanding of factors influencing home care providers’ adherence to FPE during the COVID-19 pandemic. Methods A survey was shared with home care providers during Wave 2 of the COVID-19 pandemic in Ontario. Descriptive statistics and logistic regression by FPE adherence were conducted across individual, organizational, and environmental factors. Results Of the 199 respondents (140 personal support workers; 59 nurses), 71% reported that they always used FPE as required, with greater adherence to masks (89%) than eye protection (73%). The always-adherent reported greater perceived FPE efficacy, knowledge of recommended use and perceived occupational risk, lower education, and not experiencing personal barriers (including difficulty seeing, discomfort, communication challenges). Discussion Adherence rates were relatively high. In this context, with participants reporting high levels of organizational support, individual-level factors were the significant predictors of adherence. Conclusions Initiatives addressing perceived FPE efficacy, knowledge of recommended use, perception of at-work risk, and personal barriers to use may improve FPE adherence.
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Jang HR, Kim JS. Emergency nurses' attitudes, perceptions about personal protective equipment and willingness to care for COVID-19 patients: A descriptive, cross-sectional study. J Nurs Manag 2022; 30:2514-2522. [PMID: 35700177 PMCID: PMC9353337 DOI: 10.1111/jonm.13720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 06/13/2022] [Indexed: 12/04/2022]
Abstract
Aims This study investigated emergency nurses' attitudes and perceptions about personal protective equipment and their association with the willingness to care for COVID‐19 patients. Background Emergency nurses are at increased risk for COVID‐19 infection as frontline workers and must wear personal protective equipment while attending suspected and confirmed COVID‐19 patients. Methods In September 2021, 188 nurses in four emergency departments completed online questionnaires. Results Multivariable logistic regression demonstrated that as perceptions of COVID‐19 infection risk increased by 1 point, 26% of nurses were willing to care of COVID‐19 patients. The willingness to care for COVID‐19 patients increased in their attitudes by 1.16 point and perceptions by 1.08 points about PPE. Conclusions Perceptions of the risk of infection exposure and confidence in safety of personal protective equipment are associated with nurses' willingness to care for COVID‐19 patients. Implications for Nursing Management Nurse managers need to assess nurses' needs for safety and provide a supportive climate to mitigate their concerns regarding infection risk and encourage nurses' willingness to care for patients. Nurse managers should provide precise guidelines on correct personal protective equipment use. Repetitive training on personal protective equipment should be provided to encourage nurses' adaptation to its use.
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Affiliation(s)
- Ha-Ra Jang
- Emergency Department, Gachon University Gil Medical Center, Incheon, South Korea
| | - Ji-Soo Kim
- College of Nursing, Gachon University, Incheon, South Korea
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Abere S, Oyan B, Alali DJ, Omunakwe H, Ejikem M. Viral Hepatitis B and C: Knowledge Gaps and Patterns of Preventive Practices Among Medical Doctors in Rivers State, Nigeria. Cureus 2022; 14:e22928. [PMID: 35399450 PMCID: PMC8986324 DOI: 10.7759/cureus.22928] [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: 03/07/2022] [Indexed: 11/20/2022] Open
Abstract
Introduction Hepatitis B and C viruses can result in both acute and chronic hepatitis, ranging in severity from a mild acute disease to a serious, lifelong manifestation including liver cirrhosis and hepatocellular carcinoma. This study aims to determine the knowledge and attitudes of medical doctors in Rivers State, Nigeria, to hepatitis B and C as well as their practice for prevention and treatment of the same. We also assessed their practice of universal precaution, provision, and use of personal protective tools. Methods One hundred and fifty doctors in both the private and public sectors were interviewed using self-administered questionnaires on viral hepatitis B and C. The questionnaire explored their knowledge and status of vaccination, viral hepatitis treatment, and their practice of universal safety precautions. Their responses were analyzed using SPSS version 21. Data was expressed in means and percentages. Results Out of all participants, 96% were aware that viral hepatitis B is preventable, while 46% erroneously believed that there is vaccination against the hepatitis C virus. Only 50% of the respondents were aware of the availability of a cure for hepatitis C infection, and 16% of the participants knew about drugs used for its treatment. While 76% of the doctors had been vaccinated against hepatitis B virus, only 4% had received treatment after testing positive for hepatitis B. Furthermore, nearly all respondents admit practicing universal precaution, especially during venipuncture; however, protective measures such as disposable gloves were not readily available to 20% of our respondents. There was a statistically significant association between sex and duration of practice with knowledge of hepatitis B and C, as well as between practice type and vaccination status. Conclusion This study shows that knowledge of the treatment of viral hepatitis amongst healthcare practitioners such as doctors is poor, and although universal safety precautions are practiced, personal protective equipment is not readily available for use in our healthcare setting, placing healthcare workers at risk of infections. There is also a need to encourage vaccination amongst healthcare practitioners to protect them against contagious diseases like hepatitis B and C infections.
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Sharma M, Sharma D, Sharma AK, Mohanty A, Khapre M, Kalyani CV. Barriers faced by health-care workers in use of personal protective equipment during COVID pandemic at tertiary care hospital Uttarakhand, India: A qualitative study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:74. [PMID: 35372605 PMCID: PMC8974929 DOI: 10.4103/jehp.jehp_406_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 07/30/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND To reduce the likelihood of transmission of infection to health-care workers (HCWs), personal protective equipment is used. However, wearing personal protective equipment (PPE) increases the risk of heat stress and loss of dexterity, leads to poor compliance to PPE. To address the issues of poor compliance to PPE, it was necessary to gain a deeper understanding about the factors that influence compliance. Thus this qualitative study was planned to explore barriers faced by HCWs while using PPE during a pandemic situation in a tertiary care hospital, Uttarakhand, India. MATERIALS AND METHODS A exploratory qualitative study was undertaken among health care workers involved in the care of COVID patients. FGDs were done and an unstructured interview guide with open-ended questions was used which helped to explore the factors which can be potential barriers to the HCWs while working wearing PPE. RESULTS Organizational and individual factors acting as barriers such as unavailability of essential personal protective equipment, a disharmonious work environment, lack of comfort, inadequate size, and quality of PPE were identified as the major barriers in the present study. CONCLUSION Future efforts to optimize PPE use should focus on to adequate supplies both in quality and quantity can help in avoidance of such barriers. Resources should be prioritized with the needs of the HCWs in the times of pandemic. Regular training and feedbacks are necessary for the satisfaction of HCWs and improving PPE compliance.
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Affiliation(s)
- Maneesh Sharma
- Department of Medical Surgical Nursing, College of Nursing, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Divita Sharma
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Ashok Kumar Sharma
- Department of Nursing, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Aroop Mohanty
- Department of Microbiology, All India Institute of Medical Sciences, Gorakhpur, Uttarakhand, India
| | - Meenakshi Khapre
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - C. Vasantha Kalyani
- Department of Medical Surgical Nursing, College of Nursing, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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Min HS, Moon S, Jang Y, Cho I, Jeon J, Sung HK. The Use of Personal Protective Equipment among Frontline Nurses in a Nationally Designated COVID-19 Hospital during the Pandemic. Infect Chemother 2021; 53:705-717. [PMID: 34951529 PMCID: PMC8731245 DOI: 10.3947/ic.2021.0094] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 11/04/2021] [Indexed: 11/24/2022] Open
Abstract
Background The appropriate use of personal protective equipment (PPE) can significantly reduce the risk of infection associated with caring for patients. This study aimed to investigate the knowledge, awareness, and behaviors related to the PPE usage among frontline nurses in a nationally designated coronavirus disease 2019 (COVID-19) hospital during the COVID-19 pandemic. Materials and Methods The study was performed in two phases: (1) a questionnaire survey to assess the knowledge, awareness, and behaviors related to PPE use, and (2) in-depth personal interviews to elaborate the survey findings. The questionnaires were distributed to all 121 registered nurses in three isolation wards and an intensive care unit which dedicated for patients with COVID-19 and 102 nurses completed survey (84.3% response rate). In-depth interviews were conducted with a total of 7 nurses. Results Among the survey participant, 100% stated that they knew how to protect themselves while providing nursing care and 93.1% stated that they knew the recommended PPE by task. Most survey participant mainly wore gloves, face shield, N95 or equivalent respirator, and a long-sleeved gown, but one-third of the participants sometimes used coveralls instead of long-sleeved gown. In-depth interviews, the importance of timely updated and specific guidelines for selecting the appropriate type of PPE was highlighted. The adequate supply of PPE, convenience at work, and the role of responsible leadership mainly determined behaviors related to the PPE. Conclusion As new information on COVID-19 continues to emerge, the up-to-date and specific PPE guideline with evidence should be prepared. The spread of accurate information, the role of accountable leadership, and the active communication under positive organizational culture are important for the proper use of PPE.
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Affiliation(s)
- Hye Sook Min
- Research Institute of Public Healthcare, National Medical Center, Seoul, Korea
| | - Seram Moon
- Infection Intensive Care Unit, Department of Nursing, National Medical Center, Seoul, Korea
| | - Yunmi Jang
- Infection Intensive Care Unit, Department of Nursing, National Medical Center, Seoul, Korea
| | - Inhee Cho
- Infection Intensive Care Unit, Department of Nursing, National Medical Center, Seoul, Korea
| | - Jaehyun Jeon
- Department of Internal Medicine, National Medical Center, Seoul, Korea
| | - Ho Kyung Sung
- National Emergency Medical Center, National Medical Center, Seoul, Korea.,Office for Central Infectious Disease Hospital, National Medical Center, Seoul, Korea.
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Alberto EC, McCarthy KH, Hamilton CA, Shalkevich J, Milestone ZP, Izem R, Fritzeen JL, Marsic I, Sarcevic A, O'Connell KJ, Burd RS. Personal Protective Equipment Adherence of Pediatric Resuscitation Team Members During the COVID-19 Pandemic. Ann Emerg Med 2021; 78:619-627. [PMID: 34353649 PMCID: PMC8164378 DOI: 10.1016/j.annemergmed.2021.05.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 05/11/2021] [Accepted: 05/21/2021] [Indexed: 11/26/2022]
Abstract
STUDY OBJECTIVE During the COVID-19 pandemic, health care workers have had the highest risk of infection among essential workers. Although personal protective equipment (PPE) use is associated with lower infection rates, appropriate use of PPE has been variable among health care workers, even in settings with COVID-19 patients. We aimed to evaluate the patterns of PPE adherence during emergency department resuscitations that included aerosol-generating procedures. METHODS We conducted a retrospective, video-based review of pediatric resuscitations involving one or more aerosol-generating procedures during the first 3 months of the COVID-19 pandemic in the United States (March to June 2020). Recommended adherence (complete, inadequate, absent) with 5 PPE items (headwear, eyewear, masks, gowns, gloves) and the duration of potential exposure were evaluated for individuals in the room after aerosol-generating procedure initiation. RESULTS Among the 345 health care workers observed during 19 resuscitations, 306 (88.7%) were nonadherent (inadequate or absent adherence) with the recommended use of at least 1 PPE type at some time during the resuscitation, 23 (6.7%) of whom had no PPE. One hundred and forty health care workers (40.6%) altered or removed at least 1 type of PPE during the event. The aggregate time in the resuscitation room for health care workers across all events was 118.7 hours. During this time, providers had either absent or inadequate eyewear for 46.4 hours (39.1%) and absent or inadequate masks for 35.2 hours (29.7%). CONCLUSION Full adherence with recommended PPE use was limited in a setting at increased risk for SARS-CoV-2 virus aerosolization. In addition to ensuring appropriate donning, approaches are needed for ensuring ongoing adherence with PPE recommendations during exposure.
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Affiliation(s)
- Emily C Alberto
- Division of Trauma and Burn Surgery, Children's National Hospital, Washington, DC
| | - Kathleen H McCarthy
- Division of Trauma and Burn Surgery, Children's National Hospital, Washington, DC
| | - Colleen A Hamilton
- Division of Trauma and Burn Surgery, Children's National Hospital, Washington, DC
| | - Jacob Shalkevich
- Division of Trauma and Burn Surgery, Children's National Hospital, Washington, DC
| | - Zachary P Milestone
- Division of Trauma and Burn Surgery, Children's National Hospital, Washington, DC
| | - Rima Izem
- Division of Biostatistics and Study Methods, Children's National Research Institute, Washington, DC; Department of Pediatrics and the Department of Epidemiology, George Washington University, Washington, DC
| | - Jennifer L Fritzeen
- Division of Trauma and Burn Surgery, Children's National Hospital, Washington, DC
| | - Ivan Marsic
- Department of Electrical and Computer Engineering, Rutgers University, Piscataway, NJ
| | | | - Karen J O'Connell
- Division of Emergency Medicine, Children's National Hospital, Washington, DC
| | - Randall S Burd
- Division of Trauma and Burn Surgery, Children's National Hospital, Washington, DC.
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14
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Moore R, Hayward A, Necaise K. Through Their Eyes: Health Care Worker Compliance With Personal Protective Equipment During the COVID-19 Pandemic. J Nurs Care Qual 2021; 36:294-301. [PMID: 34282072 PMCID: PMC8378415 DOI: 10.1097/ncq.0000000000000584] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Personal protective equipment (PPE) plays a critical role in protecting health care workers (HCWs). During the coronavirus disease-2019 (COVID-19) pandemic, shortages of PPE supplies drastically changed the way PPE was obtained and used by HCWs. PURPOSE The objective was to investigate the impact of the COVID-19 pandemic and patient isolation type on PPE compliance. METHODS This investigation was a survey of HCWs at a level 1 trauma teaching hospital regarding PPE compliance patterns prior to and during the COVID-19 pandemic. RESULTS HCWs reported an increase in PPE compliance during the COVID-19 pandemic. Nearly half (48.6%) of respondents reported that isolation type impacted the decision to wear PPE, of which most were likely to forgo PPE with contact precautions. CONCLUSIONS HCWs identified multiple barriers to compliance. The underutilization of PPE with contact precautions suggests that the risk of exposure is interpreted as low, and this could be a future target of education.
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Affiliation(s)
- Riley Moore
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor (Ms Moore); and Department of Infection Prevention and Control, St Joseph Mercy Hospital, Ann Arbor, Michigan, (Ms Moore and Mss Hayward and Necaise)
| | - Alexandra Hayward
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor (Ms Moore); and Department of Infection Prevention and Control, St Joseph Mercy Hospital, Ann Arbor, Michigan, (Ms Moore and Mss Hayward and Necaise)
| | - Kellee Necaise
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor (Ms Moore); and Department of Infection Prevention and Control, St Joseph Mercy Hospital, Ann Arbor, Michigan, (Ms Moore and Mss Hayward and Necaise)
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15
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Dreher A, Pietrowsky R, Loerbroks A. Attitudes, stressors and work outcomes related to the COVID-19 pandemic among dental assistants in Germany: a cross-sectional study. BMJ Open 2021; 11:e045881. [PMID: 34526331 PMCID: PMC8449838 DOI: 10.1136/bmjopen-2020-045881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES The COVID-19 pandemic has posed great challenges to medical professionals worldwide. Dental assistants (DAs) are at exceptionally high risk of infection with SARS-CoV-2 due to frequent and close patient contact and involvement in various high-risk dental procedures. This study aimed to investigate attitudes, stressors and work outcomes among DAs from all over Germany at the peak of cases in spring 2020. DESIGN Cross-sectional study. Descriptive analysis and logistic regression. SETTING Dental, maxillofacial surgery and orthodontic practices across Germany, April 2020. PARTICIPANTS Participants aged 18 years and above and currently working as DAs in Germany. PRIMARY AND SECONDARY OUTCOME MEASURES A self-devised online questionnaire was employed comprising questions on SARS-CoV-2-related attitudes, stressors and work outcomes. Validated scales assessed symptoms of depression and anxiety. RESULTS Among 1481 participating DAs (median age 35 years, 98.4% female, 91.8% working in dental practices), major stressors were uncertainty about the pandemic's temporal scope (97.9% agreement, n=1450), uncertainty about one's financial situation (87.8%, n=1301), uncertainty about how to act correctly (87.6%, n=1298) and thoughts about a possible infection during work (83.8%, n=1241). Forty-two per cent of DAs (n=622) felt sufficiently prepared for dealing with patients with SARS-CoV-2. Only 17.5% (n=259) agreed that material for personal protection was sufficiently available. Multivariable logistic regression analyses suggested that working in a dental practice, compared with orthodontic and maxillofacial surgery practices, was significantly associated with uncertainty about one's financial situation (OR 2.13 (95% CI 1.33 to 3.44)) and with the reported availability of personal protective equipment (PPE) (0.55 (0.36 to 0.84)). CONCLUSIONS Training about correct behaviour of DAs during future infectious disease outbreaks is needed, especially for DAs working in dental practices. In the future, it will also be necessary to strengthen supply chains to ensure that PPE is sufficiently available in a timely manner.
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Affiliation(s)
- Annegret Dreher
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Duesseldorf, Dusseldorf, Germany
| | - Reinhard Pietrowsky
- Institute of Experimental Psychology, Department of Clinical Psychology, University of Duesseldorf, Dusseldorf, Germany
| | - Adrian Loerbroks
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Duesseldorf, Dusseldorf, Germany
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16
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Badran EF, Jarrah S, Masadeh R, Al Hammad A, Al Shimi R, Salhout S, Al Wahabi N, Al Jaberi M, Rayyan A, Madi T, Hassan S. Assessment of Perceived Compliance and Barriers to Personal Protective Equipment Use Among Healthcare Workers During the COVID-19 Pandemic's Second Wave Surge: "Walk to Talk" Cross-Sectional Correlational Study. Disaster Med Public Health Prep 2021; 17:e45. [PMID: 34496993 PMCID: PMC8545841 DOI: 10.1017/dmp.2021.289] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE This study aimed at investigating HCWs' perceptions of PPE compliance and barriers, as well as influencing factors, in order to develop methods to combat the rise in their infection rates. METHODS During the 'second wave' surge, a cross-sectional correlational analysis was conducted over a 1-month period. It consists of HCWs from various hospital sectors that admit COVID-19 patients using an online self-administered predesigned tool. RESULTS Out of the 285 recruited participants, 36.1% had previously been diagnosed with COVID-19. Around 71% received training on PPE use. The perceived compliance was good for (PPE) usage (mean 2.60 ± 1.10). A significant higher compliance level was correlated with previous diagnosis with COVID-19, working with patients diagnosed with COVID-19, and having a direct contact with a family member older than 45 years old (P < 0.01). The main perceived barriers to the use of PPEs were unavailability of full PPEs (35%), interference with their ability to provide patient care (29%), not enough time to comply with the rigors of PPEs (23.2%) and working in emergency situations (22.5%). With regards to perceived barriers, those working with patients diagnosed with COVID-19 and those who reported having a direct contact with a family member older than 45 years old showed significantly higher level of barriers. CONCLUSION A series of measures, including prioritization of PPE acquisition, training, and monitoring to guarantee appropriate resources for IPC, are necessary to reduce transmission.
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Affiliation(s)
- Eman F Badran
- Department of Pediatrics, School of Medicine, University of Jordan, Amman, Jordan
| | - Samiha Jarrah
- Department of Nursing, School of Nursing, Applied Science Private University, Amman, Jordan
| | - Rami Masadeh
- Department of Community Health, School of Nursing, Applied Science Private University, Amman, Jordan
| | | | - Rana Al Shimi
- School of Medicine, University of Jordan, Amman, Jordan
| | - Samar Salhout
- School of Medicine, University of Jordan, Amman, Jordan
| | | | | | | | - Thaira Madi
- Department of Accreditation, Healthcare Accreditation Council, Amman, Jordan
| | - Samar Hassan
- Department of Accreditation, Healthcare Accreditation Council, Amman, Jordan
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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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Dreher A, Flake F, Pietrowsky R, Loerbroks A. Attitudes and stressors related to the SARS-CoV-2 pandemic among emergency medical services workers in Germany: a cross-sectional study. BMC Health Serv Res 2021; 21:851. [PMID: 34419024 PMCID: PMC8380100 DOI: 10.1186/s12913-021-06779-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 07/05/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim was to investigate attitudes and stressors related to the SARS-CoV-2 outbreak among emergency medical services (EMS) workers in Germany. We further aimed to detect possible changes within a 5-week period and potential determinants of attitudes and stressors. METHODS We conducted two cross-sectional studies using an online questionnaire in early April 2020 (i.e., the first peak of the SARS-CoV-2 outbreak in Germany) and five weeks later. The study instrument comprised sociodemographic items, self-devised items on pandemic-related attitudes, stressors and work outcomes, and established instruments assessing depressive symptoms and symptoms of anxiety. Logistic regression was performed to identify possible determinants. RESULTS Data of 1537 participants was included in the analysis (April: n = 1124, May: n = 413, 83.1% male, median age 32). Most participants agreed that their personal risk of infection was higher compared to the general population (April: 87.0% agreement, May: 78.9%). The greatest stressor was uncertainty about the pandemic's temporal scope (82.0 and 80.9%, respectively). Most participants (69.9, 79.7%) felt sufficiently prepared for the pandemic and only few felt burdened by their financial situation (18.8, 13.3%). Agreement to all stressors decreased from April to May except related to the childcare situation. Regression analysis identified subgroups to be burdened more frequently such as older employees, those with SARS-CoV-2 cases among their colleagues, and those with lower paramedic training levels. CONCLUSIONS We identified key SARS-CoV-2-related stressors whose levels generally decreased within a 5-week period. Our results indicate that EMS workers are less affected by existential fears and rather worry about their personal infection risk.
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Affiliation(s)
- Annegret Dreher
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Duesseldorf, Duesseldorf, Germany.
| | - Frank Flake
- German Association of Emergency Medical Service, Luebeck, Germany
| | - Reinhard Pietrowsky
- Institute of Experimental Psychology, Department of Clinical Psychology, University of Duesseldorf, Duesseldorf, Germany
| | - Adrian Loerbroks
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Duesseldorf, Duesseldorf, Germany
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19
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Brooks SK, Greenberg N, Wessely S, Rubin GJ. Factors affecting healthcare workers' compliance with social and behavioural infection control measures during emerging infectious disease outbreaks: rapid evidence review. BMJ Open 2021; 11:e049857. [PMID: 34400459 PMCID: PMC8370838 DOI: 10.1136/bmjopen-2021-049857] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE The 2019-2020 outbreak of novel coronavirus has raised concerns about nosocomial transmission. This review's aim was to explore the existing literature on emerging infectious disease outbreaks to identify factors associated with compliance with infection control measures among healthcare staff. METHODS A rapid evidence review for primary studies relevant to healthcare workers' compliance with infection control measures. RESULTS Fifty-six papers were reviewed. Staff working in emergency or intensive care settings or with contact with confirmed cases appeared more likely to comply with recommendations. There was some evidence that anxiety and concern about the risk of infection were more associated with compliance, and that monitoring from superiors could improve compliance. Observed non-compliance of colleagues could hinder compliance. Staff identified many barriers to compliance related to personal protective equipment, including availability, perceived difficulty and effectiveness, inconvenience, discomfort and a negative impact on patient care. There were many issues regarding the communication and ease of understanding of infection control guidance. CONCLUSION We recommend provision of training and education tailored for different occupational roles within the healthcare setting, managerial staff 'leading by example', ensuring adequate resources for infection control and timely provision of practical evidence-based infection control guidelines.
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Affiliation(s)
- Samantha K Brooks
- Department of Psychological Medicine, King's College London, London, UK
| | - N Greenberg
- Department of Psychological Medicine, King's College London, London, UK
| | - Simon Wessely
- Department of Psychological Medicine, King's College London, London, UK
| | - G J Rubin
- Department of Psychological Medicine, King's College London, London, UK
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20
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Alser O, Alghoul H, Alkhateeb Z, Hamdan A, Albarqouni L, Saini K. Healthcare workers preparedness for COVID-19 pandemic in the occupied Palestinian territory: a cross-sectional survey. BMC Health Serv Res 2021; 21:766. [PMID: 34344381 PMCID: PMC8329610 DOI: 10.1186/s12913-021-06804-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 07/21/2021] [Indexed: 11/10/2022] Open
Abstract
Background The COVID-19 pandemic threatens to overwhelm the capacity of a vulnerable healthcare system in the occupied Palestinian territory (oPt). We aimed to evaluate the availability of personal protective equipment (PPE) and the level of preparedness among HCWs in the oPt. Methods A cross-sectional study was conducted using a validated online questionnaire distributed through convenient sampling between March 30, 2020 and April 12, 2020. Outcomes were availability of PPE, healthcare workers (HCWs) preparedness in oPt for COVID-19 pandemic, and regional and hospital differences in oPt in terms of availability of PPE and HCWs preparedness. Descriptive statistics and univariate analysis were used in this study. Results Of 138 respondents, only 38 HCWs (27.5%) always had access to facemasks and 15 (10.9%) always had access to isolation gowns. Most HCWs did not find eye protection (n = 128, 92.8%), N95 respirators (n = 132, 95.7%), and face shields (n = 127, 92%) always available. Compared to HCWs in West Bank, those in the Gaza Strip were significantly less likely to have access to alcohol sanitizers (p = 0.03) and gloves (p < 0.001). On average, governmental hospitals were significantly less likely to have all appropriate PPE than non-governmental institutions (p = 0.001). Only 16 (11.6%) surveyed felt confident in dealing with a potential COVID-19 case, 57 (41.3%) having received any COVID-19-related training, and 57 (41.3%) not having a local hospital protocol. Conclusion HCWs in oPt appear to be underprepared and severely lacking adequate PPE provision. The lack of PPE provision will exacerbate spread of COVID-19 and deepen the crisis, whilst putting HCWs at risk. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06804-7.
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Affiliation(s)
- Osaid Alser
- Ministry of Health, Gaza Strip, occupied Palestinian territory and OxPal Medlink, Oxford, UK. .,Massachusetts General Hospital, Harvard Medical School, 165 Cambridge St, Suite 810, Boston, MA, 02114, USA.
| | - Heba Alghoul
- Faculty of Medicine, Islamic University of Gaza, Gaza, occupied Palestinian territory
| | | | - Ayah Hamdan
- Harvard T.H. Chan School of Public Health, Boston, USA
| | - Loai Albarqouni
- Institute for Evidence-Based Healthcare, Faculty of Health Sciences & Medicine, Bond University, Gold Coast, Australia
| | - Kiran Saini
- Medical Sciences Division, University of Oxford and OxPal Medlink, Oxford, UK
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21
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Seitz RM, Yaffee AQ, Peacock E, Moran TP, Pendley A, Rupp JD. Self-Reported Use of Personal Protective Equipment among Emergency Department Nurses, Physicians and Advanced Practice Providers during the 2020 COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18137076. [PMID: 34281013 PMCID: PMC8297270 DOI: 10.3390/ijerph18137076] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 06/24/2021] [Accepted: 06/28/2021] [Indexed: 11/19/2022]
Abstract
Background: Emergency departments (EDs) have seen dramatic surges in patients infected with COVID-19 and are high-risk transmission environments. Knowledge, attitudes and practice regarding personal protective equipment (PPE) among ED health care workers (HCWs) during the COVID-19 pandemic have not been studied, thus this study examines this knowledge gap. Methods: This was a cross-sectional survey of 308 HCWs in two urban EDs in Atlanta, Georgia in April and May of 2020. Results: We surveyed 308 HCWs; 137 responded (44% response rate). All HCWs reported adequate knowledge and 96% reported compliance with PPE guidelines. Reported sources of PPE information: 56.7% charge nurse, 67.3% the institutional COVID-19 website. Frequency of training was positively associated with understanding how to protect themselves and patients (OR = 1.7, 95% CI: 1.0–2.9). Conclusions: Few HCWs are willing to care for patients without PPE, and therefore we should aim for resiliency in the PPE supply chain. EDs should consider multiple communication strategies, including a website with concise information and enhanced training for key personnel, particularly the charge nurse. Attention to frequency in HCW training may be key to improve confidence in protecting themselves and patients. Findings can be leveraged by EDs to implement effective PPE training.
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22
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Costantino C, Cannizzaro E, Verso MG, Tramuto F, Maida CM, Lacca G, Alba D, Cimino L, Conforto A, Cirrincione L, Graziano G, Palmeri S, Pizzo S, Restivo V, Casuccio A, Vitale F, Mazzucco W. SARS-CoV-2 Infection in Healthcare Professionals and General Population During "First Wave" of COVID-19 Pandemic: A Cross-Sectional Study Conducted in Sicily, Italy. Front Public Health 2021; 9:644008. [PMID: 34055716 PMCID: PMC8155294 DOI: 10.3389/fpubh.2021.644008] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 03/08/2021] [Indexed: 12/31/2022] Open
Abstract
On December 31, 2019, an outbreak of lower respiratory infections was documented in Wuhan caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Since the beginning, SARS-CoV-2 has caused many infections among healthcare workers (HCWs) worldwide. Aims of this study were: a. to compare the distribution among the HCWs and the general population of SARS-CoV-2 infections in Western Sicily and Italy; b. to describe the characteristics of HCWs infected with SARS-CoV-2 in the western Sicilian healthcare context during the first wave of the epidemic diffusion in Italy. Incidence and mean age of HCWs infected with SARS-CoV-2 were comparable in Western Sicily and in the whole Italian country. The 97.6% of infections occurred in HCWs operating in non-coronavirus disease 2019 (COVID-19) working environments, while an equal distribution of cases between hospital and primary care services context was documented. Nurses and healthcare assistants, followed by physicians, were the categories more frequently infected by SARS-CoV-2. The present study suggests that healthcare workers are easily infected compared to the general population but that often infection could equally occur in hospital and non-hospital settings. Safety of HCWs in counteracting the COVID-19 pandemic must be strengthened in hospital [adequate provision of personal protective equipment (PPE), optimization of human resources, implementation of closed and independent groups of HCWs, creation of traffic control building and dedicated areas in every healthcare context] and non-hospital settings (influenza vaccination, adequate psychophysical support, including refreshments during working shifts, adequate rest, and family support).
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Affiliation(s)
- Claudio Costantino
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) "G. D'Alessandro," University of Palermo, Palermo, Italy.,COVID-19 Surveillance Western Sicily Reference Laboratory, Palermo University Hospital, Palermo, Italy
| | - Emanuele Cannizzaro
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) "G. D'Alessandro," University of Palermo, Palermo, Italy
| | - Maria Gabriella Verso
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) "G. D'Alessandro," University of Palermo, Palermo, Italy
| | - Fabio Tramuto
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) "G. D'Alessandro," University of Palermo, Palermo, Italy.,COVID-19 Surveillance Western Sicily Reference Laboratory, Palermo University Hospital, Palermo, Italy
| | - Carmelo Massimo Maida
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) "G. D'Alessandro," University of Palermo, Palermo, Italy.,COVID-19 Surveillance Western Sicily Reference Laboratory, Palermo University Hospital, Palermo, Italy
| | - Guido Lacca
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) "G. D'Alessandro," University of Palermo, Palermo, Italy
| | - Davide Alba
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) "G. D'Alessandro," University of Palermo, Palermo, Italy
| | - Livia Cimino
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) "G. D'Alessandro," University of Palermo, Palermo, Italy
| | - Arianna Conforto
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) "G. D'Alessandro," University of Palermo, Palermo, Italy
| | - Luigi Cirrincione
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) "G. D'Alessandro," University of Palermo, Palermo, Italy
| | - Giorgio Graziano
- COVID-19 Surveillance Western Sicily Reference Laboratory, Palermo University Hospital, Palermo, Italy
| | - Sara Palmeri
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) "G. D'Alessandro," University of Palermo, Palermo, Italy
| | - Stefano Pizzo
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) "G. D'Alessandro," University of Palermo, Palermo, Italy
| | - Vincenzo Restivo
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) "G. D'Alessandro," University of Palermo, Palermo, Italy.,COVID-19 Surveillance Western Sicily Reference Laboratory, Palermo University Hospital, Palermo, Italy
| | - Alessandra Casuccio
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) "G. D'Alessandro," University of Palermo, Palermo, Italy
| | - Francesco Vitale
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) "G. D'Alessandro," University of Palermo, Palermo, Italy.,COVID-19 Surveillance Western Sicily Reference Laboratory, Palermo University Hospital, Palermo, Italy
| | - Walter Mazzucco
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) "G. D'Alessandro," University of Palermo, Palermo, Italy.,COVID-19 Surveillance Western Sicily Reference Laboratory, Palermo University Hospital, Palermo, Italy
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Zhang HL, Yang S, Luo HX, You JP. The Error-Prone Operational Steps and Key Sites of Self-Contamination During Donning and Doffing of Personal Protective Equipment by Health Care Workers. Disaster Med Public Health Prep 2021; 16:1-6. [PMID: 33952368 PMCID: PMC8207547 DOI: 10.1017/dmp.2021.142] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 02/24/2021] [Accepted: 05/03/2021] [Indexed: 01/25/2023]
Abstract
OBJECTIVE This study aims to identify error-prone operational steps and key sites of self-contamination during donning and doffing of personal protective equipment (PPE). METHODS A total of 56 health care workers, including 37 nurses and 19 physicians, were recruited to don and doff the PPE recommended by the Chinese Center for Disease Control and Prevention. Operational errors and sites of self-contamination were recorded using UV-fluorescent labeling and video surveillance. RESULTS Three main errors during donning were identified: choosing a loose-fitting coverall that was difficult to handle; ignoring to inspect the seal of N95 respirator or gloves; and forgetting to pull up the zipper completely. Four main errors during doffing were identified: removing the N95 respirator in a wrong way; touching the scrubs with contaminated hands and elbows; touching contaminated external surfaces of the goggles; and performing insufficient hand hygiene. Key sites that were easily contaminated during the doffing of PPE included left hand and wrist, left lower leg, chest, and left abdomen. CONCLUSION Identifying the steps prone to errors and key sites of self-contamination in the process of PPE donning and doffing can facilitate the training of PPE use and provide detailed evidence for optimizing standardized protocols to reduce contamination.
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Affiliation(s)
- Hui-Lan Zhang
- Department of Infectious Diseases, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Sha Yang
- Department of Infectious Diseases, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Hong-Xia Luo
- Department of Infectious Diseases, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Jian-Ping You
- Department of Infectious Diseases, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
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Hetzmann MS, Mojtahedzadeh N, Nienhaus A, Harth V, Mache S. Occupational Health and Safety Measures in German Outpatient Care Services during the COVID-19 Pandemic: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18062987. [PMID: 33799465 PMCID: PMC8001336 DOI: 10.3390/ijerph18062987] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/04/2021] [Accepted: 03/11/2021] [Indexed: 12/18/2022]
Abstract
Due to the coronavirus disease 2019 (COVID-19) pandemic, outpatient caregivers are exposed to new serious health threats at work. To protect their health, effective occupational health and safety measures (OHSM) are necessary. Outpatient caregivers (n = 15) participated in semi-structured telephone interviews in May/June 2020 (1) to examine the pandemic-related OHSM that have been implemented in their outpatient care services, as well as (2) to identify their corresponding unmet needs. Interviews were recorded, transcribed and analysed by using qualitative content analysis in accordance with Mayring. Available OHSM in outpatient care services described by outpatient caregivers mainly included personal protective equipment (PPE) and surface disinfection means after an initial shortage in the first peak of the pandemic. Further OHSM implied social distancing, increased hygiene regulations and the provision of pandemic-related information by the employer, as well as the possibility to consult a company doctor. Our study revealed that OHSM were largely adapted to the health threats posed by COVID-19, however an optimum has not yet been achieved. There is still a need for improvement in the qualitative and quantitative supply of PPE, as well as on the organisational level, e.g., with regard to the development of pandemic plans or in work organisation.
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Affiliation(s)
- Mara Shirin Hetzmann
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Centre Hamburg-Eppendorf (UKE), Seewartenstr. 10, 20459 Hamburg, Germany; (M.S.H.); (N.M.); (V.H.)
| | - Natascha Mojtahedzadeh
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Centre Hamburg-Eppendorf (UKE), Seewartenstr. 10, 20459 Hamburg, Germany; (M.S.H.); (N.M.); (V.H.)
| | - Albert Nienhaus
- Department of Occupational Medicine, Hazardous Substances and Public Health, Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW), Pappelallee 33/35/37, 22089 Hamburg, Germany;
- Institute for Health Service Research in Dermatology and Nursing (IVDP), Competence Centre for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), University Medical Centre Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Volker Harth
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Centre Hamburg-Eppendorf (UKE), Seewartenstr. 10, 20459 Hamburg, Germany; (M.S.H.); (N.M.); (V.H.)
| | - Stefanie Mache
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Centre Hamburg-Eppendorf (UKE), Seewartenstr. 10, 20459 Hamburg, Germany; (M.S.H.); (N.M.); (V.H.)
- Correspondence: ; Tel.: +49-40-428-37-4313
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Rafi MA, Hasan MT, Azad DT, Alam SF, Podder V, Hossain S, Akther SMQ, Ashraf F, Hossain MG. Willingness to work during initial lockdown due to COVID-19 pandemic: Study based on an online survey among physicians of Bangladesh. PLoS One 2021; 16:e0245885. [PMID: 33561180 PMCID: PMC7874948 DOI: 10.1371/journal.pone.0245885] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 01/10/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND During the catastrophic situation of the COVID-19 pandemic, the role of the health care workers (HCWs) is the most crucial, and their absenteeism, whether due to inability or unwillingness, becomes a major concern for the national health system. Hence, the present study aimed to determine the willingness and its associated factors to work during the COVID-19 pandemic among the physicians of Bangladesh. METHODS This was a cross-sectional study conducted from April 21 to May 10, 2020, using an online survey among the Bangladeshi physicians living in the country. Both univariate and multivariable binary logistic regression models were used to determine the predictors of the willingness of the physicians to work during the COVID-19 pandemic. RESULTS More than 69% physicians reported that they were willing to work during the COVID-19 pandemic, 8.9% reported that they were not willing, while 21.4% of participants were not sure about their willingness. Younger age, having experience of treating patients during previous pandemics, working in the emergency departments and high self-reported compliance to the recommended PPE were important predictors of being willing to work during COVID-19 pandemic. Concern for family and risk of transmitting the infection to family members were most commonly reported as major barriers of working during the pandemic (30%) followed by having comorbidities (25%), lack of adequate safety measures (25%), fear of being infected (12.2%), not involved in clinical practice (12.5%) etc. CONCLUSIONS Though the majority of the physicians were willing to work during the COVID-19 pandemic, sufficient supply of PPE, support to maintain recommended quarantine and isolation policy after risky hospital duty along with adequate and effective training can increase their willingness to continue their sacred duty during this crucial pandemic.
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Affiliation(s)
| | - M. Tasdik Hasan
- Department of Primary Care and Mental Health, University of Liverpool,
Liverpool, United Kingdom
- Public Health Foundation, Dhaka, Bangladesh
| | | | | | - Vivek Podder
- Tairunnessa Memorial Medical College and Hospital, Gazipur,
Bangladesh
| | - Sahadat Hossain
- Public Health Foundation, Dhaka, Bangladesh
- Department of Public Health and Informatics, Jahangirnagar University,
Dhaka, Bangladesh
| | | | - Fatema Ashraf
- Public Health Foundation, Dhaka, Bangladesh
- Shaheed Suhrawardy Medical College Hospital, Dhaka,
Bangladesh
| | - Md. Golam Hossain
- Department of Statistics, Health Research Group, University of Rajshahi,
Rajshahi, Bangladesh
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Dreher A, Pietrowsky R, Loerbroks A. Pandemic-related attitudes, stressors and work outcomes among medical assistants during the SARS-CoV-2 ("Coronavirus") pandemic in Germany: A cross-sectional Study. PLoS One 2021; 16:e0245473. [PMID: 33444419 PMCID: PMC7808691 DOI: 10.1371/journal.pone.0245473] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 12/30/2020] [Indexed: 12/17/2022] Open
Abstract
Background The SARS-CoV-2 virus has spread rapidly around the globe since December 2019 creating much uncertainty among medical staff. Due to close patient contact, medical assistants are at increased risk of an infection. Several studies have investigated psychological consequences of the SARS-CoV-2 pandemic on medical staff, yet studies in the outpatient setting are scarce and studies addressing medical assistants are lacking. This study aimed to investigate pandemic-related stressors, attitudes, and work outcomes among medical assistants and to identify possible determinants. Methods The population under study were medical assistants across entire Germany. A self-devised online questionnaire was published between April 7th, 2020, and April 14th. including questions on pandemic-related stressors, attitudes and work outcomes. Additionally, symptoms of depression and anxiety disorder were measured by PHQ-2 and GAD-2, respectively. Logistic regression was performed to identify possible determinants. Results 2150 medical assistants provided complete data (98.0% female, mean age 37.6 years). Major stressors were uncertainty about the temporal scope of the pandemic (95.1% agreement), about how to act correctly (77.5%), feelings of not being allowed to let patients down (75.9%), uncertainty about one’s financial situation (67.4%) and about contact persons for further information (67.1%). One third (29.9%) of the study population screened positively for depression and 42.6% for anxiety disorder. Feeling burdened by one’s financial situation was significantly associated with working in specialist practices (1.32 [1.08–1.62]), caring for children (1.51 [1.22–1.87]), depression (1.28 [1.01–1.62]), and anxiety disorder (1.93 [1.55–2.39]). Feeling burdened by thoughts about virus contraction at work was also significantly associated with working in specialist practices (1.33 [1.07–1.64]), caring for children (1.33 [1.07–1.66]), depression (1.54 [1.18–2.00]), and anxiety (4.71 [3.71–5.98]). Conclusions This study provides novel evidence regarding major SARS-CoV-2 pandemic-related stressors among medical assistants and suggests need for special support for medical assistants caring for children and working in specialist practices.
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Affiliation(s)
- Annegret Dreher
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Duesseldorf, Duesseldorf, Germany
| | - Reinhard Pietrowsky
- Institute of Experimental Psychology, Department of Clinical Psychology, University of Duesseldorf, Duesseldorf, Germany
| | - Adrian Loerbroks
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Duesseldorf, Duesseldorf, Germany
- * E-mail:
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One for Everyone: A Study of User Satisfaction Among Health-Care Providers Regarding Extended Use of N95 Masks During the COVID-19 Pandemic. Disaster Med Public Health Prep 2020; 16:619-626. [PMID: 33040770 PMCID: PMC7737120 DOI: 10.1017/dmp.2020.380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Objective: This study was conducted to assess the feasibility of extended use of N95 masks in our hospital during the coronavirus disease 2019 (COVID-19) pandemic. We also studied the use pattern, user satisfaction, and issues faced during extended use of the mask. Methods: This cross-sectional study was conducted among health-care providers in a large tertiary care teaching hospital in northern India from April 1 to May 31, 2020. A list was prepared from the institute’s register, and participants were chosen by random sampling. The data collected from the physical forms were transferred to excel sheets. Results: A total of 1121 responses were received. The most common problem stated with reuse of N95 masks was loss of fit followed by damage to the slings, highlighted by 44.6% and 44.4% of the participants, respectively. A total of 476 (42.5%) participants responded that they would prefer “cup-shaped N95 mask with respirator”. The median scores regarding the satisfaction with the quality of masks and their fit was also 4 each. Conclusions: It was concluded that the extended use of N95 masks was acceptable, with more than 96% of the participants using these masks.
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A Qualitative Study of Barriers to Personal Protective Equipment Use among Laundry Workers in Government Hospitals, Hawassa, Ethiopia. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2020; 2020:5146786. [PMID: 33029156 PMCID: PMC7528124 DOI: 10.1155/2020/5146786] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/29/2020] [Accepted: 09/11/2020] [Indexed: 11/23/2022]
Abstract
Background The need to reduce the transmission of infectious diseases makes the use of personal protective equipment and safety medical devices compulsory among hospital laundry staff. The practice, however, remains to be low among hospital laundry staff members. Globally, not many studies seem to have been carried out to sufficiently tell us about the barriers to personal protective equipment use among hospital laundry workers. Related studies in Ethiopia are even fewer. This study assessed the barriers to personal protective equipment use among laundry staff of government hospitals in Hawassa City, Southern Ethiopia, 2019. Methods Two qualitative data-gathering methods—focus group discussions and key informant interviews—were used to collect data for this study. Eight focus group discussions were conducted with hospital laundry workers. Similarly, six key informant interviews were held with Infection Prevention and Patient Safety Officers. Thematic analysis was performed using Open Code 4.02. Result Organizational- and individual-level barriers such as unavailability of essential personal protective equipment, a disharmonious work environment, low perception of susceptibility, and belief about personal protective equipment interference with work performance were identified as the major barriers to personal protective equipment use in the present study. Conclusion Organizational- and individual-level barriers have been identified as causes for the low level of personal protective equipment use among hospital laundry workers. Therefore, improving institutional supplies in quantity and quality may have a positive implication for the improvement of infection prevention practices in the study area. Also, designing sustainable strategies and raising laundry workers' awareness of a safe work environment may lead to the improvement of infection prevention practices.
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Assessment of Health Workers’ Knowledge, Beliefs, Attitudes, and Use of Personal Protective Equipment for Prevention of COVID-19 Infection in Low-Resource Settings. ADVANCES IN PUBLIC HEALTH 2020. [DOI: 10.1155/2020/4619214] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly infectious disease with a potential for healthcare workers (HCWs) getting infected due to inadequate protection while attending to patients. Effective use of personal protective equipment (PPE) is key to mitigating the spread of SARS-CoV-2 infection in healthcare settings. Hence, there is a need to understand HCWs’ use of PPE in resource-limited settings and how closely the currently recommended guidelines for PPE are followed. This study assessed the HCWs’ knowledge about, attitudes towards, beliefs on, and use of PPE to prevent SARS-CoV-2 infection in a resource-limited setting. Methods. This cross-sectional study was conducted in April 2020 in Southwest and Northwest Nigeria. The selection of participants was performed via the snowball sampling technique using a 33-item, web-based, self-administered questionnaire via a social media network. We obtained relevant sociodemographic data and information on participants’ occupations and knowledge about, attitudes towards, beliefs on, and use of PPE. We analysed the data using SPSS version 23.0 for Windows (IBM, Armonk, New York, USA). A p values <0.05 were considered statistically significant. Results. A total of 290 subjects responded to the questionnaire, and 18 (6.2%) were excluded because of incomplete data. The mean age of the respondents was 32.3 ± 9.9 years. There were 116 males (42.6%). The majority of the respondents were medical doctors (114, 41.9%), followed by nurses and clinical students. Of the 272 respondents in this survey, only 70 (25.7%) had adequate knowledge about PPE. Of the respondents who presumed they had adequate knowledge about donning and doffing PPE, 94 (56%) were incorrect. The predictors of good knowledge were ages younger than 45 years (p=0.046) and practice location (p=0.009). Conclusion. This study showed that HCWs’ knowledge about, attitudes towards, and beliefs on PPE and their PPE skill in practice in Nigeria were remarkably poor. There is an urgent need for nationwide practical training on PPE use to curtail the spread of SARS-CoV-2 infection among HCWs.
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30
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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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Barratt R, Gilbert GL, Shaban RZ, Wyer M, Hor SY. Enablers of, and barriers to, optimal glove and mask use for routine care in the emergency department: an ethnographic study of Australian clinicians. Australas Emerg Care 2019; 23:105-113. [PMID: 31810897 PMCID: PMC7104090 DOI: 10.1016/j.auec.2019.10.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 09/30/2019] [Accepted: 10/04/2019] [Indexed: 12/27/2022]
Abstract
Background The risk of healthcare-acquired infection increases during outbreaks of novel infectious diseases. Emergency department (ED) clinicians are at high risk of exposure to both these and common communicable diseases. Personal protective equipment (PPE) is recommended to protect clinicians from acquiring, or becoming vectors of, infection, yet compliance is typically sub-optimal. Little is known about factors that influence use of PPE—specifically gloves and masks—during routine care in the ED. Methods This was an ethnographic study, incorporating documentation review, field observations and interviews. The theoretical domains framework (TDF) was used to aid thematic analysis and identify relevant enablers of and barriers to optimal PPE use. Results Thirty-one behavioural themes were identified that influenced participants’ use of masks and gloves. There were significant differences, namely: more reported enablers of glove use vs more barriers to mask use. Reasons included more positive unit culture towards glove use, and lower perception of risk via facial contamination. Conclusion Emerging infectious diseases, spread (among other routes) by respiratory droplets, have caused global outbreaks. Emergency clinicians should ensure that, as with gloves, the use of masks is incorporated into routine cares where appropriate. Further research which examines items of PPE independently is warranted.
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Affiliation(s)
- Ruth Barratt
- University of Sydney, Faculty of Medicine and Health, Westmead Hospital, Cnr Hawkesbury Road and, Darcy Rd, Westmead, NSW 2145, Australia.
| | - Gwendolyn L Gilbert
- University of Sydney, Faculty of Medicine and Health, Westmead Hospital, Cnr Hawkesbury Road and, Darcy Rd, Westmead, NSW 2145, Australia; University of Sydney, Marie Bashir Institute for Infectious Diseases and Biosecurity, Westmead Institute for Medical Research, 176 Hawkesbury Road, Westmead, NSW 2145, Australia; University of Sydney, Sydney Health Ethics, 92/94 Parramatta Rd, Camperdown, NSW, Australia
| | - Ramon Z Shaban
- University of Sydney, Faculty of Medicine and Health, Westmead Hospital, Cnr Hawkesbury Road and, Darcy Rd, Westmead, NSW 2145, Australia; University of Sydney, Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, Australia; University of Sydney, Marie Bashir Institute for Infectious Diseases and Biosecurity, Westmead Institute for Medical Research, 176 Hawkesbury Road, Westmead, NSW 2145, Australia; Nursing, Midwifery and Clinical Governance Directorate, Western Sydney Local Health District, Westmead Hospital, Cnr Hawkesbury Road and, Darcy Rd, Westmead, NSW 2145, Australia
| | - Mary Wyer
- University of Sydney, Marie Bashir Institute for Infectious Diseases and Biosecurity, Westmead Institute for Medical Research, 176 Hawkesbury Road, Westmead, NSW 2145, Australia; Centre for Infectious Diseases and Microbiology, Westmead Institute for Medical Research, 176 Hawkesbury Road, Westmead, NSW 2145, Australia; University of Sydney, Sydney Health Ethics, 92/94 Parramatta Rd, Camperdown, NSW, Australia
| | - Su-Yin Hor
- Centre for Infectious Diseases and Microbiology, Westmead Institute for Medical Research, 176 Hawkesbury Road, Westmead, NSW 2145, Australia; University of Sydney, Sydney Health Ethics, 92/94 Parramatta Rd, Camperdown, NSW, Australia; Centre for Health Services Management, Faculty of Health, University of Technology, Sydney, Australia
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Corrêa LB, Gomes SCS, Ferreira TF, Caldas AJM. Factors associated with use of personal protective equipment by health care professionals who suffered accidents with biological materials in the State of Maranhão, Brazil. Rev Bras Med Trab 2017; 15:340-349. [PMID: 32377591 DOI: 10.5327/z1679443520170089] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 11/06/2017] [Indexed: 11/05/2022] Open
Abstract
Background Health care professionals are at high risk for work accidents; within this context, personal protective equipment (PPE) acts as a barrier and affords protection in any situation of potential exposure to biological materials. Objective To analyze associated factors and determine the frequency of adherence to use of PPE by health care professionals from the state of Maranhão who suffered sharps injuries at work. Methods A cross-sectional epidemiological and analytical study based on secondary data from the System of Information on Notifiable Diseases (Sistema de Informação de Agravos de Notificação - SINAN) was performed with health care professionals who suffered sharps injuries from 2010 to 2015. Unadjusted analysis was performed first and then hierarchical adjusted analysis with adherence to use of PPE as response variable. Only variables with p<0.05 were considered as having association with the response variable. Results The frequency of use of PPE was 41%. At the end of hierarchical analysis, non-adherence to use of PPE remained associated with having 12 or less years of formal schooling, working at the capital/metropolitan area, percutaneous exposure, exposure to blood, needlestick injuries and improper disposal of sharps. Conclusion The frequency of adherence to PPE was relatively low among health care professionals from the state of Maranhão who were victims of accidents. Twelve years or less of formal schooling, not using PPE and improper disposal of sharps might contribute to the occurrence of work accidents at health care services.
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Affiliation(s)
| | - Sâmea Cristina Santos Gomes
- Medical Course, Center of Social Sciences, Health and Technology, UFMA - Imperatriz (MA), Brazil.,Graduate Program in Collective Health, UFMA - São Luís (MA), Brazil
| | | | - Arlenede Jesus Mendes Caldas
- Graduate Program in Nursing, UFMA - São Luís (MA), Brazil.,Graduate Program in Collective Health, UFMA - São Luís (MA), Brazil
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Fujiki S, Ishizaki T, Nakayama T. Variations in status of preparation of personal protective equipment for preventing norovirus gastroenteritis in long-term care facilities for the elderly. J Eval Clin Pract 2017; 23:1203-1210. [PMID: 28508408 DOI: 10.1111/jep.12761] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 03/28/2017] [Accepted: 03/28/2017] [Indexed: 11/27/2022]
Abstract
RATIONALE, AIM, AND OBJECTIVES Residents of long-term care facilities are highly susceptible to norovirus gastroenteritis, and each facility is concerned about the need to implement norovirus infection control. Among control measures, personal protective equipment (PPE), such as disposable gloves and masks, plays a major role in reducing infectious spread. However, the preparation status of PPE in facilities before infection outbreaks has not been reported. The aim was to clarify the implementation status of preventive measures for norovirus gastroenteritis and the cost of preparing the necessary PPE in long-term care facilities. METHOD A questionnaire survey of facilities affiliated with the Kyoto Prefecture and Osaka Prefecture branches of the Japan Association of Geriatric Health Services Facilities was conducted. The survey items were the characteristics of the facility, whether preventive measures had been implemented for norovirus gastroenteritis from October through the following March in both 2009 and 2010, and the quantities and unit prices of PPE prepared for preventive measures. RESULTS Twenty-six (11.2%) of 232 surveyed facilities (as of August 2011) answered the survey. Among them, 24 (92.3%) in 2009 and 25 (96.2%) in 2010 reported having implemented preventive measures for norovirus gastroenteritis, while 21 facilities (80.8%) in 2009 and 22 facilities (84.6%) in 2010 had prepared PPE. The median total cost for preparing the PPE needed for the preventive measures was US $2601 (range US $221-9192) in 2009 and US $3904 (range US $305-6427) in 2010. CONCLUSION Although the results need careful interpretation because of the low response rate, most of the surveyed long-term care facilities had implemented preventive measures for norovirus gastroenteritis. However, the cost of preparing the PPE needed for the preventive measures varied among the facilities.
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Affiliation(s)
- Saori Fujiki
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan
| | - Tatsuro Ishizaki
- Department of Human Care Research Team, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Takeo Nakayama
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan
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Fogel I, David O, Balik CH, Eisenkraft A, Poles L, Shental O, Kassirer M, Brosh-Nissimov T. The association between self-perceived proficiency of personal protective equipment and objective performance: An observational study during a bioterrorism simulation drill. Am J Infect Control 2017; 45:1238-1242. [PMID: 28673681 PMCID: PMC7132699 DOI: 10.1016/j.ajic.2017.05.018] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Revised: 05/25/2017] [Accepted: 05/25/2017] [Indexed: 12/25/2022]
Abstract
BACKGROUND The recent Ebola virus disease outbreak emphasized the potential misuse of personal protective equipment (PPE) by health care workers (HCWs) during such an event. We aimed to compare self-perceived proficiency of PPE use and objective performance, and identify predictors of low compliance and PPE misuse. METHODS An observational study combined with subjective questionnaires were carried out during a bioterror simulation drill. Forty-two observers evaluated performance under PPE. Mistakes were recorded and graded using a structured observational format and were correlated with the subjective questionnaires and with demographic parameters. RESULTS One hundred seventy-eight HCWs from community clinics and hospitals were included. The mean self-perceived proficiency was high (6.1 out of 7), mean level of comfort was moderate (4.0 out of 7), and mean objective performance was intermediate (9.5 out of 13). There was no correlation between comfort and objective performance scores. Self-perceived proficiency was in correlation with donning and continuous performance with PPE but not with doffing. Clinic personnel performed better than personnel in hospitals (40.3% vs 67.8% with 3 or more mistakes, respectively; P = .001). Demographic characteristics had no correlation with objective or self-perceived performance. CONCLUSIONS Self-perceived proficiency is a poor predictor of appropriate PPE use. The results suggest poor awareness of the possibility of PPE misuse.
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Akagbo SE, Nortey P, Ackumey MM. Knowledge of standard precautions and barriers to compliance among healthcare workers in the Lower Manya Krobo District, Ghana. BMC Res Notes 2017; 10:432. [PMID: 28854982 PMCID: PMC5577785 DOI: 10.1186/s13104-017-2748-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 08/23/2017] [Indexed: 12/02/2022] Open
Abstract
Background Implementing standard precautions (SP) has been a major challenge for health care workers (HCWs) especially those in developing countries thereby compromising their safety and increasing their exposure to blood-related pathogens. Compliance with safety precautions and occupational accidents among health workers are often unreported. The literature on knowledge and compliance to SP in Ghana is scanty. We report findings of a study that examined knowledge of SP, compliance and barriers to compliance with SP among HCWs in two health facilities in Ghana. Methods This is a facility-based cross-sectional study involving 100 HCWs from two health facilities in the Lower Manya Krobo District of the Eastern region. Statistical analysis summarised data on socio-demographic characteristics of respondents, knowledge of SP and compliance and barriers to SP in frequencies and percentages. Results Most respondents had been working as health staff for 0–5 years (65.0%). Generally, knowledge of the basic concepts of SP was low; only 37.0% of HCWs knew that SP includes hand washing before and after any direct contact with the patient, 39.0% knew about cough etiquettes and 40.0% knew about aseptic techniques which involve infection prevention strategies to minimise the risks of infection. Fifty percent of respondents always protect themselves against BBFs of patients. About a quarter of the respondents do not recap needles after use and 28.0% of respondents sometimes promptly wipe all blood spills. HCWs were of the opinion that wearing PPEs—such as gloves, aprons, gowns and goggles—might cause patients to panic sometimes (63.0%) and complying with SP sometimes interferes with the ability to provide care (38.0%). Sometimes, because of the demands of patient care, HCWs do not have enough time to comply with the rigours of SP (44.0%) and sometimes PPEs are not available. Conclusion Education programmes on the benefits of SP should be organised frequently. The OHS national policy together with the application of the IPC training manual in all health care facilities must be enforced. Communities of practice should be established and sanctions and rewards should be introduced to limit negative behavior and reinforce positive attitudes as regards SP.
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Affiliation(s)
| | - Priscillia Nortey
- School of Public Health, College of Health Sciences, University of Ghana, P. O. Box LG 13, Legon, Ghana
| | - Mercy M Ackumey
- School of Public Health, College of Health Sciences, University of Ghana, P. O. Box LG 13, Legon, Ghana.
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Pennathur PR, Herwaldt LA. Role of Human Factors Engineering in Infection Prevention: Gaps and Opportunities. CURRENT TREATMENT OPTIONS IN INFECTIOUS DISEASES 2017; 9:230-249. [PMID: 32226329 PMCID: PMC7100866 DOI: 10.1007/s40506-017-0123-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Human factors engineering (HFE), with its focus on studying how humans interact with systems, including their physical and organizational environment, the tools and technologies they use, and the tasks they perform, provides principles, tools, and techniques for systematically identifying important factors, for analyzing and evaluating how these factors interact to increase or decrease the risk of Healthcare-associated infections (HAI), and for identifying and implementing effective preventive measures. We reviewed the literature on HFE and infection prevention and control and identified major themes to document how researchers and infection prevention staff have used HFE methods to prevent HAIs and to identify gaps in our knowledge about the role of HFE in HAI prevention and control. Our literature review found that most studies in the healthcare domain explicitly applying (HFE) principles and methods addressed patient safety issues not infection prevention and control issues. In addition, most investigators who applied human factors principles and methods to infection prevention issues assessed only one human factors element such as training, technology evaluations, or physical environment design. The most significant gap pertains to the limited use and application of formal HFE tools and methods. Every infection prevention study need not assess all components in a system, but investigators must assess the interaction of critical system components if they want to address latent and deep-rooted human factors problems.
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Affiliation(s)
- Priyadarshini R. Pennathur
- Department of Mechanical and Industrial Engineering, 2132 Seamans Center for the Engineering Arts and Sciences, University of Iowa, Iowa City, IA USA
| | - Loreen A. Herwaldt
- Department of Medicine, University of Iowa School of Medicine, Iowa City, IA USA
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Liu MD, Chan TC, Wan CH, Lin HP, Tung TH, Hu FC, King CC. Changing risk awareness and personal protection measures for low to high pathogenic avian influenza in live-poultry markets in Taiwan, 2007 to 2012. BMC Infect Dis 2015; 15:241. [PMID: 26104109 PMCID: PMC4478710 DOI: 10.1186/s12879-015-0987-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Accepted: 06/16/2015] [Indexed: 11/29/2022] Open
Abstract
Background Outbreaks of low and high pathogenic avian influenza (LPAI, HPAI) H5N2 in chickens have occurred in Taiwan since 2003 and 2012, respectively. Fully understanding the different awareness, attitudes and protective behaviors adopted by workers in live-poultry markets (LPMWs) and local community residents (CRs) to face the challenges of LPAI and HPAI is very important to minimize viral adaptations to human populations. Methods A structural questionnaire containing information on respondents’ occupation, personal risk awareness, attitudes toward different policies, and preventative measures was administered. The two-stage survey (before and after HPAI H5N2 outbreaks) was conducted from 2007 to 2012, including: (1) 430 LPMWs and 418 CRs at LPMs from different geographical areas of Taiwan after the government announced outbreaks of LPAI H5N2 during 2007–2009, and (2) 73 LPMWs and 152 CRs at two LPMs in central Taiwan after the HPAI H5N2 outbreaks in 2012. The chi-squared test and logistic regression were applied for univariate and multivariate analyses, respectively. Results Before HPAI-H5N2 outbreaks, higher educated respondents demonstrated greater risk awareness and concerns regarding AI. However, LPM-workers protected themselves less from AI viruses (AIVs) and had lower acceptance of human or avian influenza vaccines. Most importantly, the participants who opposed (versus agreed with) the policy on banning live-poultry slaughtering at LPMs reported lower awareness of government prevention and control policies [Odds Ratio (OR): 0.76, 95 % Confidence Interval (CI): 0.56–1.01] or practiced preventive measures (OR: 0.42, 95 % CI: 0.25–0.70). After HPAI-H5N2 outbreaks, the risk awareness about AI in central Taiwan significantly increased [LPAI to HPAI LPMWs: 34.6 to 65.6 %, p < 0.05; CRs: 44.0 to 76.5 %, p < 0.05] and LPMWs’ belief in the effectiveness of vaccination to prevent human or avian influenza virus infection strikingly decreased (92.3 to 68.5 %, p < 0.05). Conclusions Risk awareness depends on high or low pathogenicity of AIVs, working in LPMs, levels of education, age, and proximity to the sites of severe AI outbreaks. Regardless of novel LPAI or HPAI virus reassortants that pose public health risks, prompt and clear risk communication focusing on both correct information about AIVs and the most appropriate preventive measures are important for effective prevention of human infection. Electronic supplementary material The online version of this article (doi:10.1186/s12879-015-0987-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ming-Der Liu
- College of General Education, Hungkuang University, Taichung (433), Taiwan. .,Center for General Education, National United University, Miaoli (360), Taiwan. .,Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, 17 Xu-Zhou Road, Taipei (100), Taiwan.
| | - Ta-Chien Chan
- Research Center for Humanities and Social Science, Academia Sinica, Taipei (115), Taiwan.
| | - Cho-Hua Wan
- Institute of Molecular and Comparative Pathobiology, School of Veterinary Medicine, National Taiwan University (NTU), Taipei (106), Taiwan.
| | - Hsiu-Ping Lin
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, 17 Xu-Zhou Road, Taipei (100), Taiwan.
| | - Tsung-Hua Tung
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, 17 Xu-Zhou Road, Taipei (100), Taiwan.
| | - Fu-Chang Hu
- Institute of Clinical Medicine and School of Nursing, College of Medicine, National Taiwan University, Taipei (100), Taiwan.
| | - Chwan-Chuen King
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, 17 Xu-Zhou Road, Taipei (100), Taiwan.
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Rozenbojm MD, Nichol K, Spielmann S, Holness DL. Hospital unit safety climate: relationship with nurses' adherence to recommended use of facial protective equipment. Am J Infect Control 2015; 43:115-20. [PMID: 25530554 PMCID: PMC7132698 DOI: 10.1016/j.ajic.2014.10.027] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 10/29/2014] [Accepted: 10/29/2014] [Indexed: 11/30/2022]
Abstract
Background Despite the existence of formal guidelines for the acute health care sector, nurses' adherence to recommended use of facial protective equipment (FPE) to prevent occupational transmission of communicable respiratory disease remains suboptimal. In addition to individual factors such as knowledge and education, group factors such as shared perceptions of organizational support for safety may influence adherence. These group safety climate perceptions can differ depending on the pace and type of work, local leadership, and organizational structure of each unit. Methods An analysis of a data set from a cross-sectional survey of 1,074 nurses in 45 units of 6 acute care hospitals was conducted. Variance components analysis was performed to examine the variance in perceptions of safety climate and adherence between units. Hierarchical linear modeling using unit-level safety climate dimensions was conducted to determine if unit-level safety climate dimensions were predictors of nurses' adherence to FPE. Results Findings revealed statistically significant unit variances in adherence and 5 of the 6 unit-level safety climate dimensions (P < .05). Furthermore, a hierarchical model suggested that tenure and unit-level communication were significantly associated with increased adherence to FPE (P < .05). Conclusion Unit-level safety climate measures varied significantly between units. Strategies to improve unit-level communication regarding safety should assist in improving adherence to FPE.
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Affiliation(s)
- Michael Diamant Rozenbojm
- Department of Occupational and Environmental Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
| | - Kathryn Nichol
- Department of Occupational and Environmental Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Collaborative Academic Practice, University Health Network, Toronto, Ontario, Canada; Centre for Research Expertise in Occupational Disease, Toronto, Ontario, Canada
| | | | - D Linn Holness
- Centre for Research Expertise in Occupational Disease, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Occupational and Environmental Health, St Michael Hospital, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
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Vandroux D. [Lessons learned from pandemic influenza severe cases since 2009]. LE PRATICIEN EN ANESTHESIE REANIMATION 2014; 18:185-191. [PMID: 32288521 PMCID: PMC7110802 DOI: 10.1016/j.pratan.2014.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Since 2009 pandemic influenza, the management of severe flu has evolved in intensive care units: mechanical ventilation modalities, use of antiviral agents, early support with extracorporeal membrane oxygenation. Many countries are implementing epidemiologic monitoring and health care networks including ECMO centers. Patient's isolation and influenza vaccination prevent nosocomial outbreak of influenza.
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Affiliation(s)
- David Vandroux
- Service de réanimation polyvalente, CHU La Réunion, site Félix-Guyon, allée des Topazes, CS 11021, 97400 Saint-Denis, La Réunion
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Bessesen MT, Savor-Price C, Simberkoff M, Reich NG, Pavia AT, Radonovich LJ. N95 respirators or surgical masks to protect healthcare workers against respiratory infections: are we there yet? Am J Respir Crit Care Med 2013; 187:904-5. [PMID: 23634856 DOI: 10.1164/rccm.201303-0581ed] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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