scholarly journals 427. Healthcare Personnel Perceived Benefit of Infection Prevention Strategies during COVID

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S314-S314
Author(s):  
Emily Sickbert-Bennett ◽  
Natalie Schnell ◽  
Shelley Summerlin-Long ◽  
Brooke Brewer ◽  
Lauren DiBiase ◽  
...  
Keyword(s):  
Infection Prevention ◽  
Medical Center ◽  
Healthcare Personnel ◽  
Prevention Policy ◽  
Prevention Strategies ◽  
Policy And Practice ◽  
Symptom Screening ◽  
Perceived Benefit ◽  
Hospital Policies ◽  
Chi Squared

Abstract Background During the COVID-19 pandemic, many infection prevention policy and practice changes were introduced to mitigate hospital transmission. Although each change had evidence-based infection prevention rationale, healthcare personnel (HCP) may have variable perceptions of their relative values. Methods Between October-December 2020, we conducted a voluntary, anonymous, IRB-approved survey of UNC Medical Center HCP regarding their views on personal protective equipment (PPE) and hospital policies designed to prevent COVID acquisition. The survey collected occupational and primary work location data (COVID unit or not) as well as their views on specific infection prevention practices during COVID. Chi squared tests (two tailed) were used to compare differences in the proportions. Results The overall results are displayed (Figure). Among the 694 HCP who responded to the survey, we found HCP were largely (68%) satisfied that the organization was taking all the necessary measures to protect them from COVID-19. A significantly greater proportion (14% more) of HCP (81.7% compared to 67.6%; 95% CI of difference 9.4-18.5%, P< 0.0001) agreed that all PPE was available to them compared to those who were confident that the organization was taking necessary steps for protection, highlighting that safety is more than simply availability of supplies. More than 90% felt that daily screening of patients/visitors and patient/visitor mask requirements were important for protecting them from acquiring COVID in the workplace and that wearing a mask themselves was a key intervention for protecting others. Fewer HCP (72-80%), although still a majority, perceived that eye protection and daily symptom screening for HCP were beneficial. Symptom screening for patients/visitors was perceived by 19% more HCP (90.9% compared to 72.2%; 95% CI of difference 15-23%) to be beneficial than symptom screening of HCP (P< 0.0001). Figure. HCP Perceived Benefit of Infection Prevention Strategies during COVID Conclusion Although infection prevention strategies were implemented based on evidence and in alignment with CDC recommendations, it is important to acknowledge that the perception and acceptance of these recommendations varied among our HCP. Compliance can only be optimized with key interventions when we seek to understand the perceptions of our staff. Disclosures David J. Weber, MD, MPH, PDI (Consultant)

scholarly journals 1154. Impact of Educational Feedback on Reducing Hospital-Onset Catheter-Associated Urinary tract Infections at an Academic Medical Center

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S412-S412
Author(s):  
Bhagyashri D Navalkele ◽  
Nora Truhett ◽  
Miranda Ward ◽  
Sheila Fletcher
Keyword(s):  
Infection Prevention ◽  
Medical Center ◽  
Academic Medical Center ◽  
Prevention Strategies ◽  
Intervention Period ◽  
Post Intervention ◽  
Frontline Staff ◽  
Post Intervention Period ◽  
Tract Infections ◽  
The Impact

Abstract Background High regulatory burden on hospital-onset (HO) infections has increased performance pressure on infection prevention programs. Despite the availability of comprehensive prevention guidelines, a major challenge has been communication with frontline staff to integrate appropriate prevention measures into practice. The objective of our study was to evaluate the impact of educational intervention on HO CAUTI rates and urinary catheter days. Methods At the University of Mississippi Medical Center, Infection prevention (IP) reports unit-based monthly HO infections via email to respective unit managers and ordering physician providers. Starting May 2018, IP assessed compliance to CAUTI prevention strategies per SHEA/IDSA practice recommendations (2014). HO CAUTI cases with noncompliance were labeled as “preventable” infections and educational justification was provided in the email report. No other interventions were introduced during the study period. CAUTI data were collected using ongoing surveillance per NHSN and used to calculate rates per 1,000 catheter days. One-way analysis of variance (ANOVA) was used to compare pre- and post-intervention data. Results Prior to intervention (July 2017–March 2018), HO CAUTI rate was 1.43 per 1,000 catheter days. In the post-intervention period (July 2018–March 2019), HO CAUTI rate decreased to 0.62 per 1,000 catheter days. Comparison of pre- and post-intervention rates showed a statistically significant reduction in HO CAUTIs (P = 0.04). The total number of catheter days reduced, but the difference was not statistically significant (8,604 vs. 7,583; P = 0.06). Of the 14 HO CAUTIs in post-intervention period, 64% (8/14) were reported preventable. The preventable causes included inappropriate urine culturing practice in asymptomatic patients (5) or as part of pan-culture without urinalysis (2), and lack of daily catheter assessment for necessity (1). Conclusion At our institute, regular educational feedback by IP to frontline staff resulted in a reduction of HO CAUTIs. Feedback measure improved accountability, awareness and engagement of frontline staff in practicing appropriate CAUTI prevention strategies. Disclosures All authors: No reported disclosures.

scholarly journals Building a PPE Monitor Team as Part of a Comprehensive COVID-19 Prevention Strategy

2021 ◽  
Vol 1 (S1) ◽  
pp. s47-s47
Author(s):  
Shelley Summerlin-Long ◽  
Brooke Brewer ◽  
Amy Selimos ◽  
Mark Buchanan ◽  
Christa Clark ◽  
...  
Keyword(s):  
Disease Transmission ◽  
Infection Prevention ◽  
Medical Center ◽  
Employee Training ◽  
Prevention Strategy ◽  
Outpatient Clinics ◽  
Healthcare Personnel ◽  
New Members ◽  
Healthcare Settings ◽  
Critical Intervention

Background: The use of personal protective equipment (PPE) is a critical intervention in preventing the spread of transmission-based infections in healthcare settings. However, contamination of the skin and clothing of healthcare personnel (HCP) frequently occurs during the doffing of PPE. In fact, nearly 40% of HCP make errors while doffing their PPE, causing them to contaminate themselves. PPE monitors are staff that help to promote their colleagues’ safety by guiding them through the PPE donning and doffing processes. With the advent of the COVID-19 pandemic in early 2020, the UNC Medical Center chose to incorporate PPE monitors as part of its comprehensive COVID-19 prevention strategy, using them in inpatient areas (including COVID-19 containment units and all other units with known or suspected SARS-CoV-2–positive patients), procedural areas, and outpatient clinics. Methods: Infection prevention and nursing developed a PPE monitoring team using redeployed staff from outpatient clinics and inpatient areas temporarily closed because of the pandemic. Employee training took place online and included fundamentals of disease transmission, hand hygiene basics, COVID-19 policies and signage, and videos on proper donning and doffing, including coaching tips. The monitors’ first shifts were supervised by experienced monitors to continue in-place training. Employees had competency sheets signed off by a supervisor. Results: The Medical Center’s nursing house supervisors took over management and deployment of the PPE monitoring team, and infection prevention staff continued to train new members. Eventually, as closed clinics and areas reopened and these PPE monitors returned to their regular positions, areas used their own staff to perform the role of PPE monitor. In the fall of 2020, a facility-wide survey was sent to all inpatient staff to assess their perceptions of the Medical Center’s efforts to protect them from acquiring COVID-19. It included a question asking how much staff agreed or disagreed that PPE monitors “play an important role in keeping our staff who care for COVID-19 patients safe.” Of the 626 staff who answered this question, 67.6% agreed or strongly agreed that PPE monitors played an important role in keeping staff safe. Thus far, there has been no direct transmission or clusters of COVID-19 involving HCP in COVID-19 containment units with PPE monitors. Conclusions: PPE monitors are an important part of a comprehensive COVID-19 prevention strategy. In early 2021, the UNC Medical Center posted and hired paid PPE monitor positions to continue this critical work in a sustainable way.Funding: NoDisclosures: None

scholarly journals COVID-19 screening system utilizing daily symptom attestation helps identify hospital employees who should be tested to protect patients and co-workers

2021 ◽  
pp. 1-17
Author(s):  
Ellen Kim ◽  
Charles Morris ◽  
Michael Klompas ◽  
Haipeng Zhang ◽  
Adam Landman ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Data Linkage ◽  
Medical Center ◽  
Academic Medical Center ◽  
Health Records ◽  
Hospital Employees ◽  
Runny Nose ◽  
Symptom Screening ◽  
Academic Medical ◽  
Chi Squared

ABSTRACT Objective: To investigate the effectiveness of a daily attestation system used by employees of a multi-institutional academic medical center, which comprised of symptom-screening, self-referrals to the Occupational Health team, and/or a COVID-19 test. Design: Retrospective cohort study of all employee attestations and COVID-19 tests performed between March and June 2020. Setting: A large multi-institutional academic medical center, including both inpatient and ambulatory settings. Participants: All employees who worked at the study site. Methods: Data was combined from the attestation system (COVIDPass), the employee database, and the electronic health records, and was analyzed using descriptive statistics including chi-squared, Wilcoxon, and Kruskal-Wallis tests. We investigated whether an association existed between symptomatic attestations by the employees and them testing positive for COVID-19. Results: After data linkage and cleaning, there were 2,117,298 attestations submitted by 65,422 employees between March and June 2020. Most attestations were asymptomatic (99.9%). The most commonly reported symptoms were sore throat (910), runny nose (637), and cough (570). Of the 2,026 employees who ever attested symptomatic, 905 employees were tested within 14 days of a symptomatic attestation, and 114 (13%) of these tests were positive. The most common symptoms associated with a positive COVID-19 test were anosmia (23% vs 4%) and fever (46% vs 19%). Conclusions: Daily symptom attestations amongst healthcare workers identified a handful of employees with Covid-19. While the number of positives was low, attestations may help keep unwell employees off campus to try to prevent transmissions.

Prevention policy and practice in the 1980s.

1982 ◽  
Vol 37 (9) ◽  
pp. 1038-1042 ◽  
Author(s):  
Edward N. Brandt
Keyword(s):  
Prevention Policy ◽  
Policy And Practice

scholarly journals Promoting COVID-19 vaccination among healthcare personnel: a multifaceted intervention at a tertiary care center in Japan

2021 ◽  
pp. 1-26
Author(s):  
Akane Takamatsu ◽  
Hitoshi Honda ◽  
Tomoya Kojima ◽  
Kengo Murata ◽  
Hilary Babcock
Keyword(s):  
Medical Center ◽  
Care Center ◽  
Tertiary Care ◽  
Vaccination Rate ◽  
Multifaceted Intervention ◽  
Vaccine Hesitancy ◽  
Healthcare Personnel ◽  
Tertiary Care Center ◽  
Post Intervention ◽  
Post Vaccination

Abstract Objective The COVID-19 vaccine may hold the key to ending the pandemic, but vaccine hesitancy is hindering the vaccination of healthcare personnel (HCP). Design Before-after trial Participants and setting Healthcare personnel at a 790-bed tertiary care center in Tokyo, Japan. Interventions A pre-vaccination questionnaire was administered to HCP to examine their perceptions of the COVID-19 vaccine. Then, a multifaceted intervention involving (1) distribution of informational leaflets to all HCP, (2) hospital-wide announcements encouraging vaccination, (3) a mandatory lecture, (4) an educational session about the vaccine for pregnant or breastfeeding HCP, and (5) allergy testing for HCP at risk of allergic reactions to the vaccine was implemented. A post-vaccination survey was also performed. Results Of 1,575 HCP eligible for enrollment, 1,224 (77.7%) responded to the questionnaire, 43.5% (n =533) expressed willingness to be vaccinated, 48.4% (n = 593) were uncertain, and 8.0% (n=98) expressed unwillingness to be vaccinated. The latter two groups were concerned about the vaccine’s safety rather than its efficacy. Post-intervention, the overall vaccination rate reached 89.7% (1,413/1,575), with 88.9% (614/691) of the pre-vaccination survey respondents who answered “unwilling” or “unsure” eventually receiving a vaccination. In the post-vaccination questionnaire, factors contributing to increased COVID-19 vaccination included information and endorsement of vaccination at the medical center (26.4%; 274/1,037). Conclusions The present, multifaceted intervention increased COVID-19 vaccinations among HCP at a Japanese hospital. Frequent support and provision of information were crucial for increasing the vaccination rate and may be applicable to the general population as well.

scholarly journals Legal Requirements for Infection Prevention and Control Training Among Healthcare Personnel

2020 ◽  
Vol 41 (S1) ◽  
pp. s70-s70
Author(s):  
Lauren Weil ◽  
Alexa Limeres ◽  
Astha KC ◽  
Carissa Holmes ◽  
Tara Holiday ◽  
...  
Keyword(s):  
Prevention And Control ◽  
Infection Prevention ◽  
Healthcare Personnel ◽  
Infection Prevention And Control ◽  
Content Areas ◽  
Training Requirements ◽  
Training Content ◽  
And Control ◽  
Dental Professionals

Background: When healthcare providers lack infection prevention and control (IPC) knowledge and skills, patient safety and quality of care can suffer. For this reason, state laws sometimes dictate IPC training; these requirements can be expressed as applying to various categories of healthcare personnel (HCP). We performed a preliminary assessment of the laws requiring IPC training across the United States. Methods: During February–July 2018, we searched WestlawNext, a legal database, for IPC training laws in 51 jurisdictions (50 states and Washington, DC). We used standard legal epidemiology methods, including an iterative search strategy to minimize results that were outside the scope of the coding criteria by reviewing results and refining search terms. A law was defined as a regulation or statute. Laws that include IPC training for healthcare personnel were collected for coding. Laws were coded to reflect applicable HCP categories and specific IPC training content areas. Results: A total of 278 laws requiring IPC training for HCP were identified (range, 1–19 per jurisdiction); 157 (56%) did not specify IPC training content areas. Among the 121 (44%) laws that did specify IPC content, 39 (32%) included training requirements that focused solely on worker protections (eg, sharps injury prevention and bloodborne pathogen protections for the healthcare provider). Among the 51 jurisdictions, dental professionals were the predominant targets: dental hygienists (n = 22; 43%), dentists (n = 20; 39%), and dental assistants (n = 18; 35%). The number of jurisdictions with laws requiring training for other HCP categories included the following: nursing assistants (n = 25; 49%), massage therapists (n = 11; 22%), registered nurses (n = 10; 20%), licensed practical nurses (n = 10; 20%), emergency medical technicians and paramedics (n = 9; 18%), dialysis technicians (n = 8; 18%), home health aides (n = 8;16%), nurse midwives (n = 7; 14%), pharmacy technicians (n = 7; 14%), pharmacists (n = 6; 12%), physician assistants (n = 4; 8%), podiatrists (n = 3; 6%), and physicians (n = 2; 4%). Conclusions: Although all jurisdictions had at least 1 healthcare personnel IPC training requirement, many of the laws lack specificity and some focus only on worker protections, rather than patient safety or quality of care. In addition, the categories of healthcare personnel regulated among jurisdictions varied widely, with dental professionals having the most training requirements. Additional IPC training requirements exist at the facility level, but this information was not analyzed as a part of this project. Further analysis is needed to inform our assessment and identify opportunities for improving IPC training requirements, such as requiring IPC training that more fully addresses patient protections.Funding: NoneDisclosures: None

scholarly journals Increasing Facemask Compliance among Healthcare Personnel during the COVID-19 Pandemic

2021 ◽  
pp. 1-22
Author(s):  
Rupak Datta ◽  
Keith Glenn ◽  
Anthony Pellegrino ◽  
Jessica Tuan ◽  
Brian Linde ◽  
...  
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Baseline Period ◽  
Healthcare Personnel ◽  
Structured Interviews ◽  
Time Series Regression ◽  
Multimodal Intervention ◽  
Direct Observations ◽  
Chi Squared ◽  
Ancillary Staff

Abstract Objective: Prior studies of universal masking have not measured facemask compliance. We performed a quality improvement study to monitor and improve facemask compliance among healthcare personnel (HCP) during the coronavirus disease 2019 (COVID-19) pandemic. Design: Mixed-methods study Setting: Tertiary care center in West Haven, Connecticut Patients: HCP including physicians, nurses, and ancillary staff Methods: Facemask compliance was measured through direct observations during a 4-week baseline period after universal masking was mandated. Frontline and management HCP completed semi-structured interviews from which a multimodal intervention was developed. Direct observations were repeated during a 14-week period following implementation of the multimodal intervention. Differences between units were evaluated with chi-squared testing using the Bonferroni correction. Facemask compliance between baseline and intervention periods was compared using time series regression. Results: Among 1,561 observations during the baseline period, median weekly facemask compliance was 82.2% (range, 80.8%-84.4%). Semi-structured interviews were performed with 16 HCP. Qualitative analysis informed the development of a multimodal intervention consisting of audit and passive feedback, active discussion, and increased communication from leadership. Among 2,651 observations during the intervention period, median weekly facemask compliance was 92.6% (range, 84.6%-97.9%). There was no difference in weekly facemask compliance between COVID-19 and non-COVID-19 units. The multimodal intervention was associated with an increase in facemask compliance (β=0.023, p=0.002) Conclusions: Facemask compliance remained suboptimal among HCP despite a facility-wide mandate for universal masking. A multimodal intervention consisting of audit and passive feedback, active discussion, and increased communication from leadership was effective in increasing facemask compliance among HCP.

scholarly journals Quantifying the Risk of Methicillin-Resistant Staphylococcus aureus (MRSA) Transmission From Patient to Healthcare Personnel in the Critical Care Setting

2020 ◽  
Vol 41 (S1) ◽  
pp. s364-s364
Author(s):  
Timileyin Adediran ◽  
Anthony Harris ◽  
J. Kristie Johnson ◽  
Mary-Claire Roghmann ◽  
Stephanie Hitchcok ◽  
...  
Keyword(s):  
Patient Care ◽  
Wound Care ◽  
Medical Center ◽  
Glucose Monitoring ◽  
Routine Care ◽  
Healthcare Personnel ◽  
Medication Delivery ◽  
Care Activity ◽  
The Mean ◽  
Specific Care

Background: Healthcare personnel (HCP) acquire MRSA on their gown and gloves during routine care activities for patients who are colonized or infected with MRSA at a rate of ∼15%. Certain care activities (eg, physical exam, care of endotracheal tube, wound care and bathing/hygiene) have been associated with a higher frequency of transmission from the patient to HCP gown and gloves than other activities (ie, administration of oral medicines, glucose monitoring, and manipulation of IV tubing/medication delivery). However, quantification of MRSA contamination and risk to subsequent patients is poorly defined. Objective: We sought to determine the mean MRSA colony-forming units (CFU) found on the gloves and gowns of HCP who acquire MRSA after various care activities involving patients with MRSA. Methods: We conducted a prospective cohort study at the University of Maryland Medical Center from December 2018 to October 2019. We identified patients colonized or infected with MRSA based on culture data from the prior 7 days. HCP performing prespecified care activities on eligible patients were observed. To isolate the risk of each care activity, HCP donned new gloves and gown prior to a specific care activity. Once that care activity was performed, HCP gloves and gown were swabbed prior to the any further care activities. HCP gloves were cultured with an E-swab by swabbing each digit up and down 3 times followed by 2 circles on the palm of their hands. HCP gowns were sampled by swabbing a 15 × 30-cm area along the beltline of the gown and along each inner forearm twice. E-swab liquid was then serially diluted and plated in triplicate on CHROMagar MRSA II (BD, Sparks, MD) to obtain CFU. We calculated the median CFUs and the interquartile range (IQR) for each specific care activity stratified by gown and gloves. Results: In total, 604 HCP–patient care interactions were observed. Table 1 displays the mean MRSA CFUs stratified by gown and gloves for each patient care activity of interest. Conclusions: The quantity of MRSA found on gowns and gloves varies depending on patient care activities. Recognition of differential transmission rates between various activities may allow different approaches to infection prevention, such as the use of personal protective equipment in high- versus low-risk activities and/or the use of more aggressive interventions for high-risk activities.Funding: NoneDisclosures: None

scholarly journals 506. Variation in Occupational Activities and Infection Prevention Practices in Healthcare Personnel Based on Exposure to COVID-19 Units

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S319-S319
Author(s):  
Jessica Howard-Anderson ◽  
Carly Adams ◽  
Amy C Sherman ◽  
William C Dube ◽  
Teresa C Smith ◽  
...  
Keyword(s):  
Infection Prevention ◽  
Panel Member ◽  
Healthcare Personnel ◽  
Similar Proportion ◽  
Review Panel ◽  
High Exposure ◽  
Material Support ◽  
Social Distancing ◽  
Occupational Activities ◽  
Low Exposure

Abstract Background Healthcare personnel (HCP) may be at increased risk for COVID-19, but differences in risk by work activities are poorly defined. Centers for Disease Control and Prevention recommends cohorting hospitalized patients with COVID-19 to reduce in-hospital transmission of SARS-CoV-2, but it is unknown if occupational and non-occupational behaviors differ based on exposure to COVID-19 units. Methods We analyzed a subset of HCP from an ongoing CDC-funded SARS-CoV-2 serosurveillance study. HCP were recruited from four Atlanta hospitals of different sizes and patient populations. All HCP completed a baseline REDCap survey. We used logistic regression to compare occupational activities and infection prevention practices among HCP stratified by exposure to COVID-19 units: low (0% of shifts), medium (1–49% of shifts) or high (≥50% of shifts). Results Of 211 HCP enrolled (36% emergency department [ED] providers, 35% inpatient RNs, 17% inpatient MDs/APPs, 7% radiology technicians and 6% respiratory therapists [RTs]), the majority (79%) were female and the median age was 35 years. Nearly half of the inpatient MD/APPs (46%) and RNs (47%) and over two-thirds of the RTs (67%) worked primarily in the ICU. Aerosol generating procedures were common among RNs, MD/APPs, and RTs (26–58% performed ≥1), but rare among ED providers (0–13% performed ≥1). Compared to HCP with low exposure to COVID-19 units, those with medium or high exposure spent a similar proportion of shifts directly at the bedside and were about as likely to practice universal masking. Being able to consistently social distance from co-workers was rare (33%); HCP with high exposure to COVID-19 units were less likely to report social distancing in the workplace compared to those with low exposure; however, this was not significantly different (OR 0.6; 95% CI: 0.3, 1.1). Concerns about personal protective equipment in COVID-19 units were similar across levels of exposure (Table 1). Table 1: Occupational activities and infection prevention behaviors of healthcare personnel stratified by level of exposure to COVID-19 units Conclusion The proportion of time spent in dedicated COVID-19 units did not appear to influence time HCP spend directly at the bedside or infection prevention practices (social distancing and universal masking) in the workplace. Risk for SARS-CoV-2 infection in HCP may depend more on factors acting at the individual level rather than those related to location of work. Disclosures Jessica Howard-Anderson, MD, Antibacterial Resistance Leadership Group (ARLG) (Other Financial or Material Support, The ARLG fellowship provides salary support for ID fellowship and mentored research training) Ben Lopman, PhD, MSc, Takeda Pharmaceuticals (Advisor or Review Panel member, Research Grant or Support, Other Financial or Material Support, Personal fees)World Health Organization (Advisor or Review Panel member, Other Financial or Material Support, Personal fees for technical advice and analysis)

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