Using effective hand hygiene practice to prevent and control infection

A coupled hand and surface hygiene criterion on heterogeneous surface touch networks

Contaminated hands of people and contaminated surfaces of inanimate objects (fomites) can spread microbes that cause enteric and respiratory infections. Thus, hand hygiene and surface hygiene are probably the most widely adopted public health interventions for controlling such infections. However, conclusions of studies on the effectiveness of these interventions are often inconsistent, likely because such studies have examined these interventions separately and thus not detected their interactions, leading to differing conclusions about their individual impact. In this study, it is proposed that hand and environmental surface hygiene (including disinfection) should be coupled to control contamination spread between surfaces, especially within heterogeneous surface touch networks. In these networks, surfaces and individuals have varying contact frequencies and patterns, reflecting the diverse and non-uniform interactions that typically occur in real-world environments. Accordingly, we propose a new theoretical framework to delineate the relationships between hand hygiene and surface hygiene. In addition, the performance of a model based on this framework that used real-world behavioural data from a graduate student office is reported. Moreover, a coupled hygiene criterion for heterogeneous networks is derived. This criterion stipulates that the product of the pathogen-removal rates for hands and surfaces must exceed a cleaning threshold to ensure the exponential decay of contamination. Failure to meet this threshold results in a non-zero steady prevalence of contamination. Furthermore, the cleaning threshold increases as the numbers of surfaces and hands increase, highlighting the significant impact of network structures on hygiene practices. Thus, extensive cleaning may be necessary in crowded indoor environments with many surfaces and occupants, such as cruise ships, to prevent super-large outbreaks of, for example, noroviral infections. Overall, the findings of this study reveal how improved and integrated hygiene control can prevent fomite transmission.

The implications of healthcare professionals wearing jewelry on patient care biosafety: observational insights and experimental approaches

The use of jewelry among healthcare professionals poses a risk of cross contamination due to potential bacterial accumulation and spread. Through a mixed-method design, this study first analyzed the implications of healthcare professionals wearing jewelry on patient care biosafety as well as on the residual bacterial load of hands and rings after hand hygiene. Firstly, an observational prevalence study to verify whether nursing professionals wear personal accessories during healthcare assistance was carried out. Second, an experimental design involving intentional contamination and hygiene of the hands, with and without a ring, was conducted. The bacterial load of both hands and rings was measured by counting colony forming units. The observational study showed that nursing workers frequently wear jewelry during healthcare assistance. Nonetheless, the experimental study did not indicate differences in bacterial contamination between hands with and without a ring, despite the hand hygiene procedure applied. In conclusion, many nursing workers wear jewelry in the workplace. Although hands with and without a ring exhibited similar microbial load, rings appeared as a potential source of bacterial contamination, reinforcing the need to remove jewelry during working hours. Hand hygiene using alcohol, or soap and water significantly decreased the bacterial load on the participants' hands, with handwashing proving to be the most efficient method for removing intentional contamination.

Mobile Applications for Learning Hand Hygiene: A Comparative Analysis

Infection control is crucial for high-quality patient care. One of the most effective and commonly used infection control procedures is hand hygiene which, it is known, requires repeated refresher training. There are many ways to educate healthcare professionals about hand hygiene, including the use of mobile applications (apps). Our aim is to review such hand hygiene apps, and to identify which have been available since 2021 and to assess their quality. We conducted a review using the PRISMA diagram to document our app selection process in the Google Play Store and Apple store in March 2024. For the evaluation of apps, we used the user version of the Mobile Application Rating Scale questionnaire (uMARS). Of 16 apps only five adhere to WHO hand hygiene guidelines. Timers were included in 12 of the 16 apps and reminders were included in 10 of 16 apps. The highest overall uMARS scoring app was Give Me 5-Hand Hygiene (4.31 ± 0.28), while Wash your hands! (1.17 ± 0.14) had the lowest score. We found that more than half of the apps were unavailable from the 2021 review. We believe that app-based education could effectively sustain hand hygiene knowledge in healthcare settings.

To Analyze and Evaluate the Rate of Compliance of Hand Hygiene Practices in a Tertiary Care Hospital: Initiation of Quality Improvement Program and Clinical Audit

INTRODUCTION

Health care as a service organization is associated with hospital-acquired infection which is drawing attention. There are concerns raised by patients, attenders, stake holders, insurers, government agencies, and regulatory bodies. The study aims to evaluate the awareness and the rate of compliance with hand hygiene.

METHODS

The audit methodology implemented is a concurrent medical record audit. The period of the audit was conducted for 6 months. A random sampling method was incorporated. The sample size was determined as 20% of the staff had been involved.

RESULTS

The Total average level of awareness of hand hygiene and adherence to policy is 93.6%. The average of all the 3 categories of compliance at 5 levels of hand hygiene in percentage is 82.3%.

DISCUSSION

Hand hygiene practices if stringently implemented will minimize the cross-transmission of infection in health care facilities. By knowing the awareness level and compliance level are measured with standardized training modules.

APPLICATIONS

Create awareness on hand hygiene and provide training with respect to the effectiveness of implementation. Incorporate hand hygiene steps as well as in the audit process.

CONCLUSIONS

There is a requirement for training with respect to the effectiveness of the implementation of the techniques. The level of care and quality of services can be made better by incorporating quality improvement programs (QIPs). By regular audits, we can raise the service quality and benchmark it.

Edible nano-encapsulated cinnamon essential oil hybrid wax coatings for enhancing apple safety against food borne pathogens

Post-harvest losses of fruits due to decay and concerns regarding microbial food safety are significant within the produce processing industry. Additionally, maintaining the quality of exported commodities to distant countries continues to pose a challenge. To address these issues, the application of bioactive compounds, such as essential oils, has gained recognition as a means to extend shelf life by acting as antimicrobials. Herein, we have undertaken an innovative approach by nano-encapsulating cinnamon-bark essential oil using whey protein concentrate and imbibing nano-encapsulates into food-grade wax commonly applied on produce surfaces. We have comprehensively examined the physical, chemical, and antimicrobial properties of this hybrid wax to evaluate its efficacy in combatting the various foodborne pathogens that frequently trouble producers and handlers in the post-harvest processing industry. The coatings as applied demonstrated a static contact angle of 85 ± 1.6°, and advancing and receding contact angles of 90 ± 1.1° and 53.0 ± 1.6°, respectively, resembling the wetting properties of natural waxes on apples. Nanoencapsulation significantly delayed the release of essential oil, increasing the half-life by 61 h compared to its unencapsulated counterparts. This delay correlated with statistically significant reductions (p = 0.05) in bacterial populations providing both immediate and delayed (up to 72 h) antibacterial effects as well as expanded fungal growth inhibition zones compared to existing wax technologies, demonstrating promising applicability for high-quality fruit storage and export. The utilization of this advanced produce wax coating technology offers considerable potential for bolstering food safety and providing enhanced protection against bacteria and fungi for produce commodities.

[Factors associated with adherence to COVID-19 preventive behaviors in ELSA-Brasil participants]

The aim of the study is to assess the adherence to recommended prevention measures during the COVID-19 pandemic and to investigate the factors associated with this adherence in the adult population. This study has a cross-sectional design and used data from the complementary study Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) - COVID, conducted from 2020 to 2021. Data were analyzed using the chi-square test and multinomial logistic regression. The sample consisted of 5,440 participants. The preventive measure with the highest adherence was the use of a face mask (95.5%). There was greater adherence by females and lower chance of adherence by white people, by those who consume alcoholic beverages, people who were retired, as well as for those who live alone or who have family members who did not follow the recommendations to stay at home. Greater adherence to preventive behaviors was observed in only one third of the participating population, which demonstrates that there was a need for greater awareness of the risks in specific populations. The findings contribute to improving our understanding about health promotion and COVID-19 prevention.

Nursing Students' Medication Administration: A Focus on Hand Hygiene and Patient Identification

BACKGROUND

Procedural failures during medication administration include a lack of appropriate hand hygiene and failure to verify patient identification prior to administration of medication. Procedural failures are common among nurses and nursing students and can lead to serious patient harm.

METHOD

A descriptive cross-sectional research design was used to collect observational data from a simulation-based experience of a medication administration scenario.

RESULTS

Thirty-five senior baccalaureate nursing students from two geographically distant universities in the United States participated in the study. All of the participants made at least one procedural failure during the simulated experience. Hand hygiene compliance was 40.3%, and patient identification compliance was 43.8%.

CONCLUSION

Students often failed to comply with medication administration safety guidelines. Nursing programs must make changes to the methods used to teach safe medication administration to prepare students for this critical skill. [J Nurs Educ. 2023;62(7):403-407.].

Effectiveness of implementing of an infection control link nurse program to improve compliance with standard precautions and hand hygiene among nurses: a quasi-experimental study

BACKGROUND

Standard precautions (SPs) including hand hygiene are considered fundamental protective measures to manage health care-associated infections (HCAIs) and to reduce occupational health hazards. The purpose of this research was to examine the effectiveness of an infection control link nurse (ICLN) program on compliance with SPs and hand hygiene among nurses.

METHODS

A quasi-experimental study with a pretest-post-test design was conducted with participating of 154 clinical nurses who worked in different wards of a tertiary referral teaching hospital in Iran. The intervention group (n = 77) had 16 infection control link nurses nominated. The control group (n = 77) received only the standard multimodal approach used in the hospital. Pre- and post-test assessment of compliance with standard precautions and hand hygiene compliance was performed via the Compliance with Standard Precautions Scale (CSPS) and the World Health Organization observational hand hygiene form. Two independent sample t-tests were used to examine differences between Compliance with Standard Precautions and hand hygiene Compliance among nurses in intervention and control group. Multiple linear regression analysis was used to assess the effect size.

RESULTS

After developing and implementing the infection control link nurse program, no statistically significant improvement was found in the Compliance with Standard Precautions (β = 5.18; 95% CI= -0.3-10.65, p = 0.064). An improvement in hand hygiene compliance was observed among nurses in the intervention group that improved statistically significant from 18.80% before the program to 37.32% 6 months after the program (β = 20.82; 95% CI 16.40-25.25, p < 0.001).

CONCLUSIONS

Given the continuing level of interest that exists in improving health care workers' hand hygiene practices, the findings of this study provide significant practical implications for hospitals seeking to improve compliance with hand hygiene among nurses, showing the effectiveness of using infection control link nurse program. Further research is needed to assess effectiveness of using infection control link nurse program to improve compliance with standard precautions.

Stepping into the Void: Lessons Learned from Civil Society Organizations during COVID-19 in Rio de Janeiro

Brazil experienced some of the highest rates of COVID-19 globally. This was complicated by the fact that 35 million of its citizens have limited access to water, a primary resource necessary to stem the spread of infectious diseases. In many cases, civil society organizations (CSOs) stepped into this void left by responsible authorities. This paper explores how CSOs in Rio de Janeiro helped populations struggling with access to water, sanitation, and hygiene (WASH) during the pandemic, and what coping strategies are transferable to similar contexts. In-depth interviews (n = 15) were conducted with CSO representatives in the metropolitan region of Rio de Janeiro. Thematic analysis of the interviews revealed that COVID-19 exacerbated pre-existing social inequities among vulnerable populations, undermining their ability to protect their health. CSOs provided emergency relief aid but faced the counterproductive actions of public authorities who promoted a narrative that diminished the risks of COVID-19 and the importance of non-pharmacological interventions. CSOs fought this narrative by promoting sensitization among vulnerable populations and partnering with other stakeholders in networks of solidarity, playing a vital role in the distribution of health-promoting services. These strategies are transferrable to other contexts where state narratives oppose public health understandings, particularly for extremely vulnerable populations.

Perceptions and attitudes of ICU physicians toward antibiotics prescribing and resistance: A cross-sectional study

Background and aim

Antibiotic resistance is a major emphasis in intensive care units (ICUs). Better understanding of ICU physicians’ perceptions, attitudes, and knowledge about antimicrobial prescribing practices could facilitate more effective interventions in fighting antimicrobial resistance in Egyptian ICUs and establishing a proper Antimicrobial Stewardship Program.

Methods

A cross-sectional questionnaire study was conducted including 92 physicians distributed across the different types of Egyptian healthcare institutions in two cities of Egypt; Cairo and El Monufia. Over a period of three months, started in December 2019 and ended in February 2020.

Results

A total of 92 Egyptian physicians were included in the study. Seventy (76.1%) of the surveyed physician strongly agreed and 22 (23.9%) agreed that antibiotic resistance is a worldwide problem. Moreover, 50 (54.3%) strongly agreed and 40 (43.4%) agreed that it is a problem in their hospitals while only 2 (2.1%) disagreed. Poor hand hygiene (67.5%), poor infection control practices by healthcare professionals (63.9%) as well as wrong practices in the management of invasive devices (68.7%), and poor environmental cleaning practices (63.4%) were considered very important causes of AMR by the majority of the surveyed ICU physicians. Almost all of the physicians (95%) rated an advice from a clinical pharmacist as very or moderately helpful intervention, while (52%) declared an advice from a microbiologist or an infectious disease specialist as very helpful.

Conclusion

The results of the present study showed that the Egyptian ICU physicians have remarkable knowledge regarding antibiotic resistance as a worldwide problem and a high sensibility toward the problem in their hospitals. The study also showed that implementation of proper AMS is an urgent need as physicians answers for the different questions in the survey showed that their attitudes and perceptions regarding antibiotic resistance and their way in prescription could be modified and improved if AMS programs with suitable training programs and local guidelines are provided among different types of Egyptian hospitals.

A survey of hand hygiene practices among Indian medical undergraduates

Background

Hand hygiene is the simplest and most effective method to prevent hospital acquired infections (HAI). Compliance with hand hygiene among health providers is, however, widely variable due to significant knowledge gaps and behavioral issues. The knowledge and practices of hand hygiene among medical undergraduate students, the future health workforce in the current COVID-19 pandemic will enable a reality check and ensure course correction at an early stage of their learning.

Methods

An online questionnaire-based survey based on a standard, validated WHO 25-point (multiple-choice question and Yes/No answers) hand hygiene survey was undertaken among medical undergraduate students in an urban city from April to June 2020. Each correct response was awarded 1 point, and an incorrect response was awarded 0 points. The maximum achievable score was 25, and the minimum score was 0.

Results

A total of 457 students with a mean age 20.24 ± 1.27 years completed the survey. A total of 415 (90.8%) students received hand hygiene training in the past three years. Overall 27.6% (n = 126) students had good knowledge, 65.4% (n = 299) had moderate and 7% (n = 32) had poor knowledge of hand hygiene practices.

Conclusions

There were significant knowledge gaps regarding hand hygiene among medical undergraduate students in the midst of the COVID-19 pandemic. There is a need to strengthen existing teaching methods to positively impact behavioral change and potentially translate into better hand hygiene compliance among the future health workforce of the country.

Prevention of occupational hand eczema in healthcare workers during the COVID-19 pandemic: a controlled intervention study

BACKGROUND

Occupational hand eczema (HE) is common among healthcare workers (HCWs) and has - in some regions of the world - increased during the COVID-19 pandemic due to related hygiene measures.

OBJECTIVES

To evaluate the efficacy of an intervention for HE prevention in HCWs during the pandemic.

METHODS

A prospective, controlled, unblinded interventional trial was conducted in 302 HCWs. The intervention group (IG) (n = 135) received online-based health education and free access to hand cleansing and hand care products. The control group (CG) (n = 167) did not receive any intervention within the study. At baseline (T0), after three (T1) and six (T2) months, participants completed standardised questionnaires. The Osnabrueck Hand Eczema Severity Index (OHSI) was assessed at T0 and T2.

RESULTS

During the observation period, there were no new HE cases in the IG (n = 115) and 12 cases (8.8%) in the CG (n = 136). OHSI values at T2 were lower in the IG (b = -1.44, P < 0.001). Daily use of emollients was higher at work (b = 1.73, P < 0.001) and at home (b = 1.62, P < 0.001) in the IG at T2.

CONCLUSIONS

The intervention was effective in HE prevention and improving skin care behaviour during the COVID-19 pandemic. This article is protected by copyright. All rights reserved.

Contribution of nursing research to fighting against COVID-19 pandemic. A systematic review

Introduction: The 2019 coronavirus disease (COVID-19) pandemic, should be an opportunity to ensure greater visibility of nursing in health systems and society worldwide. Objective: Review and synthesize the patterns on COVID-19 and nursing research, identifying the main journals, country of origin, language, topics, designs, and area of applicability of the results. Materials and Methods: Systematic review. Searches in PubMed, CINAHL, LILACS, and EMBASE databases (from the inception of the pandemic to May 15, 2020) were performed. Articles of any language related were related to SARS-CoV-2 infection or COVID-19 disease and nursing in any of its roles (care, management, education, among others) and using any epidemiological design or a scientific report were included. Two reviewers independently selected the studies and extracted the data. The main findings from the included studies were summarized through narrative synthesis and descriptive tables. The characteristics of the studies were presented as absolute values and proportions. Results: Three hundred and sixty-five articles were assessed for eligibility. Thirty-eight were included, published in 28 journals. Of those, 53.57% (n=15) were nursing specific. Most articles were “narrative reviews”, accounting for 23.68% (n=9). Most studies were conducted in China (n=18, 47.37%), followed by the United Kingdom and the United States. Thirty-four (89.47%) articles were published in English, followed by Portuguese and Chinese. We identified five areas of application of the results, and the most frequent was the “clinical” setting with 47.00% (n=18). Discussion: These findings are crucial to give visibility to nursing work during the emergency of the COVID-19 pandemic. Mental health was the main research topic, while the clinical setting concentrates the major number of articles. This pattern was aligned with the challenges of the initial phase of the pandemic. Conclusion: Future research should explore the current state of evidence in the main topics identified in this review and continue to give visibility to work carried out by nursing in the emergency of the COVID-19 pandemic.

COVID-19 Preventive Behaviors and Influencing Factors in the Thai Population: A Web-Based Survey

Objectives

To identify factors influencing COVID-19 preventive behaviors among the Thai population.

Methods

A cross-sectional web-based survey was used. A total of 6,521 Thai people completed the survey. The multiple linear regression analysis was performed to identify factors that influenced coronavirus disease 2019 (COVID-19) preventive behaviors. The Predisposing, Reinforcing, and Enabling Constructs in Educational Diagnosis and Evaluation (PRECEDE) model was applied to propose factors influencing COVID-19 preventive behaviors.

Results

The factors that mostly influenced COVID-19 prevention behaviors when controlling for the other variables are social support (β = 0.173, p < 0.001) follow by age (β = 0.162, p < 0.001), flu-like symptoms (β = 0.130, p < 0.001), gender (β = -0.084, p < 0.001), perceived risk of exposure (β = 0.035, p < 0.05), lock down policy (β = 0.029, p < 0.05), and residential area (β = -0.027, p < 0.05), respectively. These factors explained 52% of the COVID-19 preventive behaviors in Thai population.

Conclusion

The result of this study was a foundation for further studies on different groups of people to develop different strategies to adopt preventive behaviors to reduce the spread of the COVID-19.

Challenges and impact of COVID-19 lockdown on Indian optometry practice: A survey-based study

PURPOSE

The Indian government announced a nationwide lockdown as a preventive measure to control the prevailing COVID-19 pandemic. This survey was developed and conducted to assess the impact of lockdown on Indian optometry practice.

METHODS

A survey questionnaire was designed and circulated across the optometrists practicing in India through multiple social media platforms. All the data were extracted and only valid response were analyzed and reported.

RESULTS

A total of 691 optometrists participated in the survey. Most of the participants (22.25%) were in private practice followed by academics (14.89%). Among the valid responses collected, it was found that 43.37% of the respondents were consulting patients during the lockdown. Of these, 27.17% of optometrists were examining infectious cases and 48.68% were examining all the patients who came for consultation. Approximately 50.94% of the participated optometrist had begun telephonic/e‑mail/video consultations. In addition, 64.48% reported that optometrists were at an equal risk of clinching COVID‑19 on comparison with other domains during patient examination. Nearly 30.44% respondents felt that optometrists would face challenges in approaching the patient post COVID-19 considering the close working distance.

CONCLUSION

A proportion of optometrist have switched to some form of teleconsultation in order to aid patients during this prevailing pandemic. Regulatory bodies should issue appropriate guidelines regarding the safe optometry practice for the betterment of both patient and practitioners during face-to-face consultation.

Effects of skin washing frequency on the epidermal barrier function and inflammatory processes of the epidermis: an experimental study

BACKGROUND

Increased hand hygiene measures during the COVID-19 pandemic have led to an increased quantum of hand eczema (HE).

OBJECTIVES

To examine the effects of varying washing frequencies using current mild cleansing agents - alongside with the effect of a rehydrating cream - on the epidermal barrier function and inflammatory processes of the stratum corneum (SC).

METHODS

Standardized skin washings on the volar aspects of the lower arms of skin healthy volunteers were performed using the Automated Cleansing Device either 5 or 11 times within 4 hours for 60 seconds each with a standard cleanser, a lipid-containing syndet, or a lipid-containing syndet followed by one-time application of a rehydrating cream. Skin bioengineering parameters (transepidermal water loss, SC hydration, erythema, and SC pH) and biochemical / immunological parameters (IL-1α, IL-1αRA, and Natural Moisturizing Factor) of SC samples collected by tape stripping were assessed.

RESULTS

All applied washing procedures provided comparable, mild effects on the epidermal barrier function and skin inflammation.

CONCLUSIONS

Occupational skin cleansers seem to have improved regarding skin barrier damaging effects. To further corroborate this, a study design, modified on the basis of our findings, applying longer washing periods for consecutive days seems desirable. This article is protected by copyright. All rights reserved.

Knowledge and Practice of Antibiotic Management and Prudent Prescribing among Polish Medical Doctors

Antimicrobial resistance (AMR) is an urgent public health issue. The role of medical doctors in proper antibiotic use is crucial. The aim of this study was to evaluate the knowledge and practices of Polish doctors of antimicrobial prescribing and antibiotic resistance. The study group consisted of 504 medical doctors with an average age 32.8 ± 5.9 years, mostly women (65%). The paper questionnaire was developed on the basis of a survey tool developed by the European Centre for Disease Prevention and Control (ECDC) and Public Health England (PHE). According to our study, physicians were aware that: taking antibiotics has side effects, antibiotics cannot be used against viruses, unnecessary use of antibiotics leads to AMR and that healthy people can carry resistant bacteria (each item ≥98% correct responses). Only 47% of respondents knew that the use of antibiotics as growth stimulants in livestock is illegal in the EU. Of the respondents, 98.61% saw the connection between prescribing antibiotics and AMR. However, 65.28% of the respondents reported a lack of appropriate materials on AMR counseling. Nearly 92.5% of participants "never" or "rarely" gave out resources on prudent antibiotic use. Physicians in Poland underestimate the role of hand hygiene in stimulating antibiotic resistance (ABR) (74.4%), while demonstrating satisfying knowledge about antimicrobial use, the clinical application of antimicrobial guidelines and prevention of ABR. However, educational interventions are needed to help lead challenging communication with assertive patients. Appropriate patient resources would be helpful in reaching this goal.

Personal protective equipment in Covid-19: Evidence-based quality and analysis of YouTube videos after one year of pandemic

Background

The correct use of personal protective equipment (PPE) during the Covid-19 pandemic is mandatory to minimize the contagion risk. The current study aimed to evaluate quality information of YouTube videos on PPE use during the pandemic.

Methods

Using Google Trend tool, the frequency of worldwide YouTube and Google searches for “donning and doffing” was examined. We queried YouTube with terms related to donning and doffing of PPE. Validated quality information assessment tools were used.

Results

From the December 1, 2019 to the January 31, 2021, according to YouTube and Google searches, both peaks occurred in April 2020 (69.5% and 72.0%, respectively). Of all videos, 144 were eligible for the analyses. According to misinformation tool, 90 (62.5%) videos contained inaccuracies. The median DISCERN Section 1 ranged from 3 to 5. The median DISCERN Section 3 was 4. According to Global Quality Score, 8.3% (n = 12), 14.6% (n = 21), 22.9% (n = 33), 30.6% (n = 44) and 23.6% (n = 34) were classified as poor, partially poor, moderate, partially good and excellent quality videos, respectively.

Conclusions

Nowadays, YouTube may be recommended as a reliable source of information. Nevertheless, a not negligible number of videos contained inaccuracies. Future authors should improve videos contents to provide more complete information.

An Intra-COVID-19 Assessment of Hand Hygiene Facility, Policy and Staff Compliance in Two Hospitals in Sierra Leone: Is There a Difference between Regional and Capital City Hospitals?

Although hand hygiene (HH) is the most effective intervention to reduce the spread of infections, there are limited data on HH facilities, policy, and compliance in sub-Saharan Africa. This cross-sectional study is aimed at assessing HH using the WHO HH self-assessment framework, HH technical reference manual, and a modified infection control self-assessment tool in two hospitals in Sierra Leone. Only 10% and 9% of regional and capital city hospitals had running tap water, respectively. Veronica buckets were the resources for HH in 89% of units in the regional hospital and 92% of units in capital city hospital. Constant supply of soap and alcohol-based hand rub was available in 82% and 68%; and 74% and 79% of units in the capital city and regional hospitals, respectively. Only 10% of the units in both hospitals had hand-drying facilities and functional sinks. Overall HH compliance for the two hospitals was 18.6% and was higher in the regional (20.8%) than the capital city (17.0%) hospitals. The HH levels for the capital city and regional hospitals were 277.5 and 262.5 respectively. Despite the COVID-19 pandemic, there are still challenges with HH compliance in Sierra Leone. It is, therefore, necessary to strengthen the HH multi-modal strategy.

Respiratory assessment: undertaking a physical examination of the chest in adults

Nurses frequently encounter patients in respiratory distress or with respiratory complications, whether from acute disease or a long-term condition. A physical examination of the chest should be conducted as part of a comprehensive respiratory assessment of the patient, and should follow a systematic approach that includes inspection, palpation, percussion and auscultation. Nurses undertaking these hands-on components of respiratory assessments need to have adequate knowledge of the procedures involved, as well as practical skills that need to be practised under supervision. This article outlines how to undertake a physical examination of the chest in adults.

Risk assessment for COVID-19 transmission at household level in sub-Saharan Africa: evidence from DHS

Household habitat conditions matter for diseases transmission and control, especially in the case of the novel coronavirus (COVID-19). These conditions include availability and adequacy of sanitation facilities, and number of persons per room. Despite this, little attention is being paid to these conditions as a pathway to understanding the transmission and prevention of COVID-19, especially in Africa, where household habitat conditions are largely suboptimal. This study assesses household sanitation and isolation capacities to understand the COVID-19 transmission risk at household level across Africa. We conducted a secondary analysis of the Demographic and Health Surveys of 16 African countries implemented between 2015 and 2018 to understand the status of households for prevention of COVID-19 transmission in home. We assessed handwashing capacity and self-isolation capacity using multiple parameters, and identified households with elderly persons, who are most at risk of the disease. We fitted two-level random intercept logit models to explore independent relationships among the three indicators, while controlling for the selected explanatory variables. Handwashing capacity was highest in Tanzania (48.2%), and lowest in Chad (4.2%), varying by household location (urban or rural), as well as household wealth. Isolation capacity was highest in South Africa (77.4%), and lowest in Ethiopia (30.9%). Senegal had the largest proportion of households with an elderly person (42.1%), while Angola (16.4%) had the lowest. There were strong, independent relationships between handwashing and isolation capacities in a majority of countries. Also, strong associations were found between isolation capacity and presence of older persons in households. Household capacity for COVID-19 prevention varied significantly across countries, with those having elderly household members not necessarily having the best handwashing or isolation capacity. In view of the age risk factors of COVID-19 transmission, and its dependence on handwashing and isolation capacities of households, each country needs to use the extant information on its risk status to shape communication and intervention strategies that will help limit the impact of the disease in its population across Africa.

Hand hygiene by the nursing team in home care: a cross-sectional study

OBJECTIVE

to identify whether nursing professionals carry out hand hygiene, how they do it, and what resources are available for this practice during home visits.

METHOD

cross-sectional study conducted in a public Home Care service. The World Health Organization instrument was used to observe the hand hygiene technique, the time of performance, and the product used.

RESULTS

a total of 940 hand hygiene opportunities taking place in 231 home visits were observed. Overall adherence was 14.4%, with the practice of hand hygiene being higher after contact with the patient (53.7%). Before aseptic procedures, after risk/exposure to body fluids, after contact with the patient's environment, and before contact with the patient, adherence was 0.4%. Regarding the quality of the technique, in none of the 135 practices the recommended steps were followed. As for the structure available in the households, 35 (15.2%) had accessible sinks and none had liquid soap and alcohol-based formulation.

CONCLUSION

adherence to hand hygiene by nursing professionals in home care was low, the technique was not performed, and households did not have resources for the practice.

SARS-CoV-2 (COVID-19) and the Teaching of Ignaz Semmelweis and Florence Nightingale: a Lesson of Public Health from History, after the "Introduction of Handwashing" (1847)

Ignác Fülöp Semmelweis (1818-1865) and Florence Nightingale (1820-1910) were two important personalities in the history of medicine and public health. They dealt with the problem of handwashing. Semmelweis is also known as the "father of hand hygiene"; just in 1847 he discovered the etiology and prophylaxis of puerperal sepsis and imposed a new rule mandating handwashing with chlorine for doctors. He also tried to persuade European scientific community of the advantages of handwashing. During the Crimean War, in Scutary (Turkey), Florence Nightingale strengthened handwashing and other hygiene practices in the war hospital where she worked and her handwashing practices reached a reductions in infections. Unfortunately the hygiene practices promoted by Semmelweis and Nightingale were not widely adopted. In general handwashing promotion stood still for over a century. During current pandemic SARS-CoV-2 (COVID-19) one of the most important way to prevent the spread of the virus is still to wash the hands frequently.

Like soldiers on the front - a qualitative study understanding the frontline healthcare professionals' experience of treating and caring for patients with COVID-19

BACKGROUND

While people in the societies must stay home to reduce spread of the newly discovered coronavirus, healthcare professionals do the exact opposite. For them the coronavirus is an enemy that should be defeated as a part of one's job. They do, however, also have a daily life with family while doing their work obligations. The purpose of this study was to gain an in-depth understanding of the frontline healthcare professionals' experience of balancing work life and family life during the COVID-19 pandemic.

METHODS

A sample of 22 frontline healthcare professionals caring for patients with COVID-19 was included and interviewed individually from May to August 2020. Ricoeur's phenomenological hermeneutical philosophy inspired the methodology in this study.

RESULT

Frontline healthcare professionals treating and caring for patients with COVID-19 are, voluntarily or involuntarily, forced to be ready to change departments as well as being ready to face the unknown coronavirus. The frontline work leads to feelings of being abandoned among their families and friends due to the threat of bringing the infection home and spreading the virus. Although healthcare professionals are facing a working life filled with uncertainty and unpredictability impacting their family life, they express opposing feelings of being a part of something bigger.

CONCLUSIONS

The work life balance for these healthcare professionals is threatened by changes in professional responsibilities, working hours and shifts. Fear of bringing the infection home challenges them ethically and creates a distance between healthcare professionals and their families, leading to a conflict within the individual if their work on the frontline is worth it - or if it is a too high price to pay. Despite facing a working life filled with uncertainty and unpredictability the healthcare professionals are being a part of something bigger that contributes to a fighting spirit and professional pride outweighing the negative consequences; like being soldiers on the front.

Adherence to COVID-19 preventive measures and associated factors among pregnant women in Ghana

OBJECTIVE

To assess adherence to COVID-19 preventive measures and its associated factors among pregnant women in Ghana.

METHODS

This was a cross-sectional study conducted in the Nabdam district, Ghana. Data were collected from 527 pregnant women randomly selected from antenatal care clinics from 16 healthcare facilities. Descriptive statistics were used to assess the prevalence of adherence to COVID-19 preventive measures. Multivariable logistic regression was used to estimate the factors associated with COVID-19 preventive measures, whilst adjusting for potential confounders.

RESULTS

The prevalence of wearing a face mask 18.0% (95% CI: 14.73%, 21.32%); of handwashing/hand sanitising 31.7% (95% CI: 27.70%, 35.67%), and of social distancing, 22.0% (95% CI: 18.46%, 25.56%). Multivariable logistic regression analysis revealed that knowledge of COVID-19 symptoms [Adjusted odds ratios (aOR): 2.86, 95% CI: 1.03, 7.89] and knowledge of COVID-19 transmission via contaminated surfaces/objects (aOR: 4.60, 95% CI: 1.23, 17.18) were associated with wearing a face mask. Pregnant women who knew that avoiding the touching of eyes, nose and mouth can prevent COVID-19 (aOR: 2.71, 95% CI: 1.01, 7.28), and knowledge of the virus being transmitted via contaminated objects/surfaces (aOR: 4.08, 95% CI: 1.42, 11.76), were associated with handwashing/hand sanitising. Knowledge of COVID-19 transmission via contaminated surfaces/objects (aOR: 15.27, 95% CI: 1.87, 124.43) was also associated with social distancing.

CONCLUSION

The findings of our study suggest that knowledge of COVID-19 symptoms, transmission and preventive measures may play an important role in the practice of preventive measures against COVID-19 among pregnant women.

The Dark Triad of Personality's Relationship with Compliance towards COVID-19 Pandemic Recommendations along with Anxiety and Depressive Symptoms in Polish Citizens

The outbreak of the COVID-19 pandemic forced everyone to comply with rules of a sanitary regime and social distancing on a daily basis. The aim of our research was to assess the differences in the levels of Dark Triad traits between people who obeyed and disobeyed the pandemic restrictions. Additionally, we considered the possible correlation between the Dark Triad and the intensity of symptoms of depression and anxiety. A total of 604 Polish participants, whose average age was 28.95 ± 11.27 years, completed an online survey which measured Dark Triad traits using the Polish version of the Dirty Dozen test. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS). The results revealed a possible relationship between personality traits and compliance with pandemic restrictions. Individuals with higher levels of psychopathy tended to disobey newly introduced rules. On the other hand, a higher level of subclinical narcissism might have contributed to a better civil compliance. The results showed a significant positive correlation between the intensity of the Dark Triad and the occurrence of depressive symptoms. Furthermore, narcissism was linked to anxiety symptoms. These results can contribute to a better understanding of behavioural patterns during the COVID-19 pandemic within the group of individuals who exhibit the Dark Triad traits. Our conclusions might help to identify individuals who are particularly vulnerable to mental health problems.

Protection Measures, Dental Education, and Covid-19 Spread: A Brief Narrative Review

Objectives

The aim of the study was to evaluate and check the international literature for Covid-19 prevention and dental education.

Materials and Methods

A review of the international literature was performed, including articles in English about different aspects of transmission, preventive actions, and educational topics.

Results

As a result, it seems that the better way to avoid contagion was represented by the use of personal protective equipment and handwashing in conjunction with social distancing and treatment limitation.

Conclusions

Dental treatment limitation to emergencies, social distancing, and online teaching seemed to be the key to limit the Covid-19 outbreak, although there was no evidence of a universal guideline. This suggests that we have to establish general guidelines to avoid a second rush of contagion and limit the spread of infection in the future.

How has the pandemic lockdown changed our daily facial skin care habits?

Background

During the COVID‐19 pandemic, Poland implemented widespread closure of beauty and cosmetic services to control the virus spread.

Aims

The aim of this study was to investigate the impact of the SARS‐CoV‐2 pandemic on home face care of women and to analyze changes that have occurred in their daily habits.

Patients/Methods

An online survey was completed by 412 women living in Poland during the spring lockdown. Questions addressed changes in face care during the COVID‐19 pandemic.

Results and conclusions

Our questionnaire showed that during the lockdown, women were more interested in face skincare, more often followed the procedure of full home skincare. And after implementing the changes in skincare, they saw a good impact on their skin. The significance of the Internet also increased considerably, not only as a source of knowledge in the field of cosmetology but also as a thriving market selling cosmetic products.

Assessment of knowledge and attitude of allied healthcare professionals about COVID-19 across Saudi Arabia

BACKGROUND

The coronavirus disease (COVID-19) has shown a catastrophic effect on mankind. The allied healthcare professionals (AHPs) play a pivotal role against COVID-19.

OBJECTIVES

To appraise the knowledge and attitude about COVID-19 of AHPs working across Saudi Arabia.

METHODS

This cross-sectional study was conducted using Qualtrics software to gather data from all five regions of Saudi Arabia during the nationwide lockdown in April 2020. Complete responses of 195 AHPs were considered for analysis. The questionnaire consisted of 15 and 14 questions on knowledge and attitude, respectively. The overall scores of each domain were calculated and modified Bloom's criterion was applied to categorize them into a three-point ordinal scale. Statistical analysis was performed using Chi-square test along with multivariate logistic regression for significant parameters.

RESULTS

The AHPs displayed a moderate level of knowledge (58.2%) and a good level of attitude (80%). The AHPs were found to have a non-significant (P > 0.05) difference in the level of knowledge within age, gender, region, occupation, educational level, organizational setup and years of experience. The attitude of AHPs working in a private setup has shown a 2.8 times (P = 0.020) higher risk for having moderate/poor attitude compared to the AHPs working in a government organization.

CONCLUSIONS

AHPs displayed a moderate level of knowledge and good attitude towards COVID-19. Emphasis should be given to continuous professional development in order to enhance their knowledge. Furthermore, strategies should be developed in the private sector to positively reinforce the attitude of AHPs.

COVID-19 outbreak in Brazil: adherence to national preventive measures and impact on people's lives, an online survey

Background

The first case of COVID-19 infection was diagnosed in Brazil 26th February 2020. By March 16th, physical distancing and confinement measures were implemented by the Brazilian government. Little is known about how these measures were followed up by the Brazilian people and their impact on daily routine.

Methods

In early April 2020, using an online platform, we organized an online survey among adults living in Brazil about their COVID-19 preventive behavior and impact on their daily routine.

Results

Data from 23,896 respondents were analyzed (mean age: 47.4 years). Due to COVID-19 restrictions, half (51.1%) of the professionals reported working from home. Regular handwashing was practiced by 98.7% of participants; 92.6% reported adhering to the 1.5-2 m physical distancing rule, but only 45.5% wore a face mask when going outside. While 29.3% of respondents found it relatively easy to stay at home, indoor confinement was extremely difficult for 7.9% of participants. Moreover, 11% of participants were extremely worried about their health during the COVID-19 epidemic. Younger people, male, persons living in a rural area/village or popular neighbourhoods, students and workers reported less preventive behaviour.

Conclusion

Restrictive measures markedly affected the daily and professional routines of Brazilians. Participants showed a satisfactory level of adherence to national COVID-19 prevention guidelines. Qualitative and follow-up studies are needed to monitor the impact of COVID-19 in the Brazilian society.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10222-z.

COVID-19 Dentistry-Related Aspects: A Literature Overview

A new coronavirus (Sars-CoV-2) was detected in China at the end of 2019 and has since caused a worldwide pandemic. This virus is responsible for an acute respiratory syndrome (COVID-19), distinguished by a potentially lethal interstitial bilateral pneumonia. Because Sars-CoV-2 is highly infective through airborne contamination, the high infection risk in the dental environment is a serious problem for both professional practitioners and patients. This literature overview provides a description of the clinical aspects of COVID-19 and its transmission, while supplying valuable information regarding protection and prevention measures.

Simulation Centers and Simulation-Based Education during the Time of COVID 19: A Multi-Center Best Practice Position Paper by the World Academic Council of Emergency Medicine

COVID 19 struck us all like a bolt of lightning and for the past 10 months, it has tested our resilience, agility, creativity, and adaptability in all aspects of our lives and work. Simulation centers and simulation-based educational programs have not been spared. Rather than wait for the pandemic to be over before commencing operations and training, we have been actively looking at programs, reviewing alternative methods such as e-learning, use of virtual learning platforms, decentralization of training using in situ simulation (ISS) modeling, partnerships with relevant clinical departments, cross-training of staff to attain useful secondary skills, and many other alternatives and substitutes. It has been an eye-opening journey as we maximize our staff's talent and potential in new adoptions and stretching our goals beyond what we deemed was possible. This paper shares perspectives from simulation centers; The SingHealth Duke NUS Institute of Medical Simulation which is integrated with an Academic Medical Center in Singapore, The Robert and Dorothy Rector Clinical Skills and Simulation Center, which is integrated with Thomas Jefferson University, Oakhill Emergency Department, Florida State University Emergency Medicine Program, Florida, USA and The Wellington Regional Simulation and skills center. It describes the experiences from the time when COVID 19 first struck countries around the world to the current state whereby the simulation centers have stWWarting functioning in their "new norm." These centers were representative examples of those in countries which had extremely heavy (USA), moderate (Singapore) as well as light (New Zealand) load of COVID 19 cases in the nation. Whichever categories these centers were in, they all faced disruption and had to make the necessary adjustments, aligning with national policies and advisories. As there is no existing tried and tested model for the running of a simulation center during an infectious disease pandemic, this can serve as a landmark reference paper, as we continue to fine-tune and prepare for the next new, emerging infectious disease or crisis.

Infection and Risk Perception of SARS-CoV-2 among Airport Workers: A Mixed Methods Study

This is a mixed-methods research study carried out on a cohort of airport workers during the SARS-CoV-2 pandemic. We used quantitative and qualitative methods to describe the infection and risk perception of SARS-CoV-2 in a cohort of workers at the International Airport El Dorado/Luis Carlos Galán Sarmiento in Bogotá, Colombia. An incidence of SARS-CoV-2 infection of 7.9% was found in the workers. A high perception of risk was associated with activities such as using public transport. Risk perception is strongly influenced by practices related to work conditions and environments. These findings could help us understand the pandemic's dynamics and the conceptions of the risk of transmission to promote policies on health and safety in this group of workers.

Un produit de santé peut-il changer de statut au gré des circonstances ? Éléments de réflexion avec l’exemple précis du savon

Le savon est un produit cosmétique d’usage courant, en cette période de pandémie, puisque son utilisation fait partie des gestes barrières. Capable de prévenir une maladie, la COVID-19, il devrait donc être commercialisé sous un statut de médicament. Si l’on considère l’histoire du savon, on se rend compte de la complexité de son statut. Selon les périodes, il a été considéré comme un produit d’hygiène et/ou comme un excipient ou encore comme une substance active, permettant la réalisation de médicaments ou de cosmétiques destinés à traiter aussi bien la gale que les brûlures, de réaliser des purges ou de mettre au point des préparations pour adoucir ou blanchir les mains ou pour allonger les cils. L’emploi du terme « savon » étant extrêmement galvaudé, l’établissement d’une réglementation visant à clarifier cette situation s’imposerait.

Minimizing cross transmission of SARS-CoV-2 in obstetric ultrasound during COVID-19 pandemic

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)-associated infection (COVID-19) is affecting populations worldwide. This statement may serve as guidance for infection prevention and safe ultrasound practices during the COVID-19 pandemic. Ultrasound examination is a fundamental part of obstetric care, yet it is a potential vector for transmission of SARS-CoV-2. Decontamination methods should always be implemented for ultrasound equipment, especially in the presence of suspected or confirmed COVID-19 cases. There must be workflow policies to protect pregnant women and healthcare providers from nosocomial cross transmission of SARS-CoV-2. Cleaning and disinfecting of equipment must be in accordance with their potential of pathogen transmission. Consider using telemedicine and genetic technologies as an adjunctive of obstetric ultrasound to reduce patient crowding. Patient triage and education of healthcare providers of infection prevention are crucial to minimize cross contamination of SARS-CoV-2 during obstetric ultrasound.

Hand hygiene knowledge, attitude, practice and hand microflora analysis of staff nurses in a rural tertiary care hospital

Introduction:

Hand hygiene play crucial role in infectious control. The present research is on accessing Knowledge, attitude, and practice of nursing staff regarding hand washing. Human hands are covered with several commensal and pathogenic microorganism. Pathogenic bacterial species especially Staphylococcus species are the most common to participate in nosocomial infections.

Methods:

Total 300 hand swab samples were taken from 150 nursing staffs followed by filling the questionnaire form. Standard culture media (Blood agar and MacConkey agar) were used to isolate the microorganisms. Microbial identification was done by using standard biochemical tests.

Results:

Our study concluded that over all staff members had moderate knowledge and attitude regarding hand washing. Coagulase-negative Staphylococcus isolates were the most dominant bacteria. Occurrence of Staphylococcus aureus was relatively less.

Conclusions:

Creating awareness and education regarding hand hygiene would definitely increase the attitude and practice of health care workers to minimizing the nosocomial infection.

Understanding the COVID-19 pandemic from a gender perspective

Under the threat of the new coronavirus pandemic, women have been uniquely impacted financially, economically, and socially. However, in terms of disease incidence and lethality, women perform better than men. The main reason is that, in addition to women's own hormonal protection, women's immune systems are superior to those of men. Women also exhibit more protective behavior (e.g., hand-washing) and more closely follow protection guidelines, which greatly reduces the chance of infection. In the future, more studies that adopt a gender perspective are needed to understand the various dilemmas faced by women in infectious diseases and pandemics; only then can women demonstrate better outcomes.

Reduktion des Besucher- und Personal- assoziierten Infektionsrisikos durch komplexe Intervention auf perinatologischen Stationen

Ziel dieser prospektiven, klinischen Studie ist der Nachweis für perinatologische Stationen: (a) dass eine komplexe Intervention die Compliance bzgl. Händehygiene bei Besuchern, Geschwisterkindern und Personal verbessert und (b) dass automatisierte Sprachansagen am Desinfektionsmittelspender die Rate effektiv durchgeführter Händedesinfektionen erhöhen.

Studiendesign (a) Pretest-Posttest-Follow-up-Design mit Kontroll- (1–12/2016), Interventions- (1–12/2017), Follow-up-Kontroll-Periode (1/2018–12/2019). (b) Randomisiert-kontrollierter Studienteil im quasi Crossover-Design. Primäre Endpunkte: (a) Desinfektionsmittelverbrauch pro Patientenliegetag (b) DMV am Desinfektionsmittelspender pro Passant am Eingang zu den Stationen.

Ergebnisse Die multimodale Strategie innerhalb der Interventions-Periode zeigte einen relevanten positiven Effekt auf die Compliance bzgl. Händehygiene (Interventions-Periode: 26,2% mehr DMV; p=0,088). Sprachansagen steigern den Desinfektionsmittelverbrauch um 28,6% (p=0,025). Sekundärendpunkte: Die Odds-Ratio für den Vergleich hochpositiver Fingerkuppen-Abklatschproben zwischen Kontroll- und Interventions-Periode bei Besucher-Kindern lag bei 0,35 (95% CI [0,1074–0,9708] p=0,039).

Schlussfolgerungen Eine komplexe Intervention inklusive Awareness-fördernder Maßnahmen und automatisierter Sprachansagen am Desinfektionsmittelspender sind auf perinatologischen Stationen wirksam. Installation von Desinfektionsmittelspendern in kindgerechter Position und adäquates Informationsmaterial spricht auch Kinder an. Die Daten stellen z. B. in einer Pandemie-Situation einen wichtigen Beitrag zur Optimierung von Handhygienemaßnahmen von Personal und Besuchern in Krankenhäusern dar.

Strategies to Prevent Healthcare-Associated Infections: A Narrative Overview

Healthcare-associated infections (HCAIs) are a major source of morbidity and mortality and are the second most prevalent cause of death. Furthermore, it has been reported that for every one-hundred patients admitted to hospital, seven patients in high-income economies and ten in emerging and low-income economies acquire at least one type of HCAI. Currently, almost all pathogenic microorganisms have developed antimicrobial resistance, and few new antimicrobials are being developed and brought to market. The literature search for this narrative review was performed by searching bibliographic databases (including Google Scholar and PubMed) using the search terms: "Strategies," "Prevention," and "Healthcare-Associated Infections," followed by snowballing references cited by critical articles. We found that although hand hygiene is a centuries-old concept, it is still the primary strategy used around the world to prevent HCAIs. It forms one of a bundle of approaches used to clean and maintain a safe hospital environment and to stop the transmission of contagious and infectious microorganisms, including multidrug-resistant microbes. Finally, antibiotic stewardship also has a crucial role in reducing the impact of HCAIs through conserving currently available antimicrobials.

Knowledge of Health Care Professionals and Medical Students Regarding Covid-19 in a Tertiary Care Hospital in Nepal

INTRODUCTION

The lack of knowledge among health care professionals leads to diagnostic delays, further spread of disease, and poor infection control practices. Health care professionals must be updated knowledge regarding COVID-19. This study aims to assess the knowledge of health care professionals regarding COVID -19 in a medical college in Chitwan.

METHODS

A Knowledge, Attitude and Practice Study was carried out in a tertiary care hospital in Chitwan, Nepal from April 22, 2020, to April 28, 2020. The institutional review committee of Chitwan Medical College provided ethical approval for the research. Data were collected with an online questionnaire using Google forms. The questionnaire was sent out to 724 potential responders who included health care professionals from medical, dental, nursing, and allied health sciences in Chitwan Medical College. A convenient sampling method was used for data collection. Data were analyzed using Statistical Package of Social Sciences.

RESULTS

A total of 181 respondents completed the web survey. Overall, a total of 35 (19.3%) respondents were found to have "Good" knowledge; 105 (58%) respondents had "Fair" knowledge and 41 (22.7%) respondents had "Poor" knowledge regarding various aspects of COVID-19. There was no significant difference among the various health professional groups in their knowledge scores under the four knowledge domains.

CONCLUSIONS

The study of knowledge of health care professionals could act as a reference for the prevention and better management of COVID-19. This study shows that there is a need to implement periodic educational interventions and training programs on infection control practices for COVID-19 across all healthcare professions.

COVID-19 crisis, safe reopening of simulation centres and the new normal: food for thought

Background

The world is facing a massive burden from the coronavirus disease 2019 (COVID-19) pandemic. Governments took the extraordinary step of locking down their own countries to curb the spread of the coronavirus. After weeks of severe restrictions, countries have begun to relax their strict lockdown measures. However, reopening will not be back to normal.

Simulation facilities (SF) are training spaces that enable health professionals and students to learn skills and procedures in a safe and protected environment. Today’s clinicians and students have an expectation that simulation laboratories are part of lifelong healthcare education. There is great uncertainty about how COVID-19 will impact future training in SF. In particular, the delivery of training activities will benefit of adequate safety measures implemented for all individuals involved.

This paper discusses how to safely reopen SF in the post-lockdown phase.

Main body

The paper outlines 10 focus points and provides operational tips and recommendations consistent with current international guidelines to reopen SF safely in the post-lockdown phase. Considering a variety of national advices and regulations which describe initial measures for the reopening of workplaces as well as international public health recommendations, we provide points of reflection that can guide decision-makers and SF leaders on how to develop local approaches to specific challenges. The tips have been laid out taking also into account two main factors: (a) the SF audience, mainly consisting of undergraduate and postgraduate healthcare professionals, who might face exposure to COVID-19 infection, and (b) for many simulation-based activities, such as teamwork training, adequate physical distancing cannot be maintained.

Conclusions

The planning of future activities will have to be based not only on safety but also on flexibility principles.

Sharing common methods consistent with national and international health guidelines, while taking into account the specific characteristics of the different contexts and centres, will ultimately foster dissemination of good practices.

This article seeks to further the conversation. It is our hope that this manuscript will prompt research about the impact of such mitigation procedures and measures in different countries.

Publications on COVID-19 in High Impact Factor Journals: A Bibliometric Analysis

The COVID-19 pandemic caused by the SARS-CoV-2 virus has sickened more than six million people worldwide. This context has led to an abundance of publications quickly since the beginning of the outbreak. In a few months, thousands of scientific papers have appeared. This article aims to provide a bibliometric analysis of the publications on COVID-19 in five high-impact journals indexed to the Web of Science Core Collection's Science Citation Index Expanded (SCI-EXPANDED) including The Lancet, New England Journal of Medicine, Science, Nature, and JAMA-Journal of the American Medical Association. We found 169 documents associated with the search criteria. The findings indicate that China, the United States, and the United Kingdom are the most represented countries in these publications, The Lancet is the journal with the highest number of contributions with 66% of documents, and the University of Hong Kong leads the ranking of institutions. Future bibliometric and scientometric studies on COVID-19 should provide updated information to analyse other relevant indicators in this field.

Modeling the effects of intervention strategies on COVID-19 transmission dynamics

OBJECTIVES

To model the effects of continuous, intermittent, and stepping-down social distancing (SD) strategies and personal protection measures on COVID-19 transmission dynamics.

METHODS

Constant, intermittent, and stepping-down SD strategies were modeled at 4 mean magnitudes (5%, 10 %, 15 % and 20 %), 2 time windows (40-days, 80-days), and 2 levels of personal caution (30 % and 50 %).

RESULTS

The stepping-down strategy was the best long-term SD strategy to minimize the peak number of active COVID-19 cases and associated deaths. The stepping-down strategy also resulted in a reduction in total time required to SD over a two-year period by 6.5 % compared to an intermittent or constant SD strategy. An 80-day SD time-window was statistically more effective in maintaining control over the COVID-19 pandemic than a 40-day window. However, the results were dependent upon 50 % of people being cautious (engaging in personal protection measures).

CONCLUSION

If people exercise caution while in public by protecting themselves (e.g., wearing a facemask, proper hand hygiene and avoid agglomeration) the magnitude and duration of SD necessary to maintain control over the pandemic can be reduced. Our models suggest that the most effective way to reduce SD over a two-year period is a stepping-down approach every 80 days. According to our model, this method would prevent a second peak and the number of intensive care units needed per day would be within the threshold of those currently available.

Hygienic and cosmetic care habits in polish women during COVID-19 pandemic

Background

COVID‐19 pandemic influences a lot of aspects of human life. Particularly, hygienic habits are affected.

Objectives

Changes in washing and cosmetic standards during the pandemic toward the past are in the focus of our interest.

Material and Methods

The questionnaire study was conducted anonymously in 140 women. The examination concerned pre‐ and during‐pandemic routine hygiene activities such as hands washing, hair washing, bathing, the use of disinfectants, and use of specific type of cosmetics.

Results and Discussion

Compared were data before and during pandemic. Responders declared increased handwashing and taking shower after coming back home and after using local city transportation. We found also that increased use of disinfectants during COVID‐19 pandemic. In contrary to that, number of people washing their hair decreased slightly. Work documents that profile of used cosmetics was changed; increasing hand cream use and decreasing in makeup cosmetics. Nearly, half of the respondents declare that they will maintain new habits also after the pandemic has ended.