COVID-19 contagious health care personnel 5-day early return-to-work program

BACKGROUND

COVID-19 contagious health care personnel (HCP) who are self-isolating for a 10-day period increases burden to workforce shortages. Implementation of a 5-day early return-to-work (RTW) program may reduce self-isolation periods, without increasing transmission risk, during the COVID-19 pandemic.

DESIGN AND METHODS

This observational cohort quality improvement study included newly diagnosed COVID-19 HCP at a multifacility health care system. The program allowed HCP to return to work 6 days after date of a positive test result if they were not immunocompromised, had mild and improving symptoms, and self-reported a SARS-CoV-2 antigen negative test on day 5.

RESULTS

Between January 4 and April 3, 2022, 1,023 HCP self-enrolled and 344 (33.6%) self-reported negative test results. Among these, 161 (46.8%) self-reported negative test results on day 5 and were eligible for early RTW on day 6. A total of 714 days were saved from missed work in self-isolation. The number of tests purchased, dispensed, and reported per day of HCP time saved was 4.4. No transmission events were observed originating from HCP who participated in early RTW.

CONCLUSION

Implementing a 5-day early RTW program that includes HCP self-reporting SARS-CoV-2 antigen test results can increase staffing availability, while maintaining a low risk of SARS-CoV-2 transmission.

Healthcare personnel early return-to-work program after higher-risk SARS-CoV-2 exposure: A learning health system quality improvement project

Background

Incidence of health care personnel (HCP) with a higher-risk SARS-CoV-2 exposure and subsequent 14-day quarantine period adds substantial burden on the workforce. Implementation of an early return-to-work (RTW) program may reduce quarantine periods for asymptomatic HCP and reduce workforce shortages during the COVID-19 pandemic.

Methods

This observational quality improvement study included asymptomatic HCP of a multi-facility health care system with higher-risk workplace or non-household community SARS-CoV-2 exposure ≤4 days. The program allowed HCP to return to work 8 days after exposure if they remained asymptomatic through day 7 with day 5-7 SARS-CoV-2 nucleic acid amplification test result negative.

Results

Between January 4 and June 25, 2021, 384 HCP were enrolled, 333 (86.7%) remained asymptomatic and of these, 323 (97%) tested negative and were early RTW eligible. Mean days in quarantine was 8.16 (SD 2.40). Median day of early RTW was 8 (range 6-9, IQR 8-8). Mean days saved from missed work was 1.84 (SD 0.52). A total of 297 (92%) HCP did RTW ≤10 days from exposure and days saved from missed work was 546.48.

Conclusions

Implementing an HCP early RTW program is a clinical approach for COVID-19 workplace safety that can increase staffing availability, while maintaining a low risk of SARS-CoV-2 transmission.

549 Use of 3D Printing Technology in Surgical Planning and Decision Making in ENT Skull Base Surgery- An Axial 3D First in Northern Ireland

Discussion

The use of a 3D model allowed for visualisation of tumour size and relation to surrounding anatomy, particularly the absence of dural involvement within the fontal sinus. It assisted in surgical planning. The use of the 3D skull was beneficial for patient as it allowed less invasive surgery and therefore shorter recovery time. It was also beneficial for the hospital organisation as it lowered resource requirements of theatre time, hospital bed days and staff resources. One limitation of the 3D printed skull was that the fine lamellae ethmoid air cells were not shown due to the manufacturing process.

Conclusions

The use of 3D printing is becoming increasingly popular as a surgical aid. We found the use of the 3D skull to be useful in individualised surgical planning for endoscopic sinus surgery.

554 An Unusual Case of a “Hernia Within a Hernia” Resulting in Small Bowel Obstruction and Strangulation

Discussion

The patient had a known, recurrent wide necked ventral hernia. However, this was the first presentation of the new, smaller hernia. This case is unusual in that it demonstrates a multi-locular “hernia within a hernia”. Although multi-locular hernias have been previously described, there is a paucity of literature on these.

Conclusions

This “hernia within a hernia” is an uncommon surgical finding for which there is limited literature. Clearly without urgent surgical intervention there would be an increase in morbidity and mortality.

What do young adults know about palliative care? A cross-sectional survey

OBJECTIVES

A public health approach to palliative care that reorientates care towards the public is advocated in global policy. The public are drivers in identifying care priorities and partners in finding solutions to care issues; however, a necessary prerequisite is that the public knows what palliative care is and what it can achieve. The aim of this study was to investigate what young adults, an important cohort of the public, know about palliative care and identify key predictors of knowledge.

STUDY DESIGN

This is a cross-sectional online survey.

METHODS

A cross-sectional online survey measured knowledge of palliative care using the Palliative Care Knowledge Scale (PaCKS), with young adults (aged 18-29 years) recruited from a university in the UK. Data relating to demographic characteristics and familiarity and experience of palliative care were collected, with descriptive, bivariate and multivariate analyses undertaken to determine respondents' knowledge levels and key predictors.

RESULTS

In total, 83% (n = 710) of respondents (n = 859) had heard of the term palliative care. The mean score on the PaCKS was 8.87 (standard deviation = 3.4, range = 0-13); men had lower levels of knowledge (P = 0.016). Most respondents were aware that palliative care is not specifically for those with cancer or exclusively for older populations. They were unsure of timing and other key aspects reporting significant levels of 'I don't 'know' responses. Linear regression analysis demonstrated that familiarity and experience of palliative care moderated demographic influences (age, gender, education level) on knowledge (β = 0.45, P < 0.001).

CONCLUSIONS

The findings suggest that despite high levels of awareness and familiarity with the term, significant numbers of respondents indicated a lack of knowledge of palliative care rather than inaccurate knowledge. This suggests the need for public health organisations to partner with palliative care sectors to develop and disseminate clear unequivocal messaging relating to the breadth of palliative care that both informs and engages young adults.

Three-dimensional PET reconstruction with time-of-flight measurement

The interest in fully three-dimensional image reconstruction, especially in positron emission tomography (PET) has significantly increased for the last few years. Taking into account the cross-plane gamma rays in a three-dimensional reconstruction algorithm improves the sensitivity. At LETI, our specialty in PET is the time-of-flight (TOF) measurement. Thus, we present in this article two reconstruction techniques for 3D TOF PET. The first is a backprojection-convolution algorithm. Due to the redundancy in the 3D data set, there exists an infinite number of filters. As Defrise and co-workers did for classical tomography, we established a general condition that characterizes the filters and propose an algorithm with a factorizable filter. However, this first technique requires an acquisition system with revolution symmetry. Thus, we present a second one which is adapted to a detection geometry with a small number of angular positions. It consists of a multi-image deconvolution algorithm with Wiener filter.