scholarly journals COVID-19 infection prevention and control procedures and institutional trust: Perceptions of Canadian intensive care and emergency department nurses

2021 ◽  
Author(s):  
Sarah L. Silverberg ◽  
Lisa M. Puchalski Ritchie ◽  
Nina Gobat ◽  
Srinivas Murthy
Keyword(s):  
Emergency Department ◽  
Intensive Care ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Infection Prevention And Control ◽  
Institutional Trust ◽  
Emergency Department Nurses ◽  
Control Procedures ◽  
And Control

scholarly journals Mortality after surgery with SARS-CoV-2 infection in England: A population-wide epidemiological study

2021 ◽  
Author(s):  
T. E. F. Abbott ◽  
A. J. Fowler ◽  
T. D. Dobbs ◽  
J. Gibson ◽  
T. Shahid ◽  
...  
Keyword(s):  
National Health Service ◽  
Health Service ◽  
High Mortality ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Surgical Patients ◽  
Infection Prevention And Control ◽  
List Type ◽  
Control Procedures ◽  
And Control

AbstractObjectivesTo confirm the incidence of perioperative SARS-CoV-2 infection and associated mortality after surgery.Design and settingAnalysis of routine electronic health record data from National Health Service (NHS) hospitals in England.MethodsWe extracted data from Hospital Episode Statistics in England describing adult patients undergoing surgery between 1st January 2020 and 31st October 2020. The exposure was SARS-CoV-2 infection defined by ICD-10 codes. The primary outcome measure was 90-day in-hospital mortality. Data were analysed using multivariable logistic regression adjusted for age, sex, Charlson co-morbidity index, index of multiple deprivation, presence of cancer, surgical procedure type and admission acuity. Results are presented as n (%) and odds ratios (OR) with 95% confidence intervals.ResultsWe identified 1,972,153 patients undergoing surgery of whom 11,940 (0.6%) had SARS-CoV-2. In total, 19,100 (1.0%) patients died in hospital. SARS-CoV-2 infection was associated with a much greater risk of death (SARS-CoV-2: 2,618/11,940 [21.9%] vs No SARS-CoV-2: 16,482/1,960,213 [0.8%]; OR: 5.8 [5.5 – 6.1]; p<0.001). Amongst patients undergoing elective surgery 1,030/1,374,985 (0.1%) had SARS-CoV-2 of whom 83/1,030 (8.1%) died, compared with 1,092/1,373,955 (0.1%) patients without SARS-CoV-2 (OR: 29.0 [22.5 −37.3]; p<0.001). Amongst patients undergoing emergency surgery 9,742/437,891 (2.2%) patients had SARS-CoV-2, of whom 2,466/9,742 (25.3%) died compared with 14,817/428,149 (3.5%) patients without SARS-CoV-2 (OR: 5.7 [5.4 – 6.0]; p<0.001).ConclusionsThe low incidence of SARS-CoV-2 infection in NHS surgical pathways suggests current infection prevention and control policies are highly effective. However, the high mortality amongst patients with SARS-CoV-2 suggests these precautions cannot be safely relaxed.Summary boxesWhat is already known on this topicHigh mortality rates have been reported amongst surgical patients who develop COVID-19 but we don’t know how this compares to the concurrent surgical population unaffected by COVID-19.Strict infection prevention and control procedures have substantially reduced the capacity of surgical treatment pathways in many hospitals.The very large backlog in delayed and cancelled surgical procedures is a growing public health concern.What this study addsFewer than 1 in 100 surgical patients are affected by COVID-19 in the English National Health Service.Elective surgical patients who do develop COVID-19 are 30 times more likely to die while in hospital.Infection prevention and control procedures in NHS surgical pathways are highly effective but cannot be safely relaxed.

Challenges facing psychiatric intensive care during COVID-19: mitigating the risk of transmission on a PICU

2020 ◽  
Vol 16 (2) ◽  
pp. 89-94
Author(s):  
Ria Pugh ◽  
Luke Skelton ◽  
Lucy Blake ◽  
Margaret Butler ◽  
Bethan Harries ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Infection Prevention And Control ◽  
Care Services ◽  
Control Protocols ◽  
And Control

This is the second of five brief reports which document the experience of a London psychiatric intensive care unit (PICU) which faced an outbreak of COVID-19 infection relatively early in the pandemic. The aim is to share what was learnt and examine the challenges which lie ahead for psychiatric intensive care services. This article will present how the PICU adapted to the changing landscape with consideration of the COVID-19 infectious window, infection prevention and control protocols and the unique challenges faced by PICU services.

Evolution of the environmental microbiota of a new neonatal intensive care unit (NICU) and implications for infection prevention and control

2020 ◽  
pp. 1-6
Author(s):  
Philip Zachariah ◽  
Felix D. Rozenberg ◽  
Stephania Stump ◽  
Dagmara I. Moscoso ◽  
Ganga Krishnamurthy ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Prevention And Control ◽  
Neonatal Intensive Care ◽  
Infection Prevention ◽  
Patient Transfer ◽  
Infection Prevention And Control ◽  
Differential Abundance ◽  
And Control

Abstract Objective: To describe changes in the environmental microbiota of a new neonatal intensive care unit (NICU) and potential implications for infection prevention and control (IPC) efforts. Design: Prospective observational study. Setting: A newly constructed level IV neonatal cardiac intensive care unit (NCICU) before and after patient introduction and the original NICU prior to patient transfer. Methods: Environmental samples were obtained from the original NICU prior to patient transfer to a new NCICU. Serial sampling of patient rooms and provider areas of the new NICU was conducted immediately prior to patient introduction and over an 11-month study period. Microbiota at each sampling point were characterized using Illumina sequencing of the V3/V4 region of the 16S rRNA gene. Microbiota characteristics (α and β diversity and differential abundance) were compared based on time, location, and clinical factors (room-level antibiotic use and patient turnover). Results: An immediate increase in the environmental differential abundance of gut anaerobes were seen after patient introduction. There was an increase in the relative abundance of Staphylococcus spp, Klebsiella spp, Pseudomonas spp, and Streptococcus spp over time. The new NCICU consistently showed more diverse microbiota and remained distinct from the original NICU. The microbiota of the provider areas of the NCICU eventually formed a cluster separate from the patient rooms. Patient turnover increased room-level microbiota diversity. Conclusion: Microbiota characteristics of the new NICU were distinct from the original ICU despite housing similar patients. Patient and provider areas developed distinct microbiota profiles. Non–culture-based methods may be a useful adjunct to current IPC practice.

A Decrease in the Number of Cases of Necrotizing Enterocolitis Associated with the Enhancement of Infection Prevention and Control Measures during aStaphylococcus aureusOutbreak in a Neonatal Intensive Care Unit

2012 ◽  
Vol 33 (1) ◽  
pp. 29-33 ◽  
Author(s):  
Brigitte Lemyre ◽  
Wenlong Xiu ◽  
Nicole Rouvinez Bouali ◽  
Janet Brintnell ◽  
Jo-Anne Janigan ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Birth Weight ◽  
Prevention And Control ◽  
Neonatal Intensive Care ◽  
Infection Prevention ◽  
Control Measures ◽  
Infection Prevention And Control ◽  
Prevention And Control Measures ◽  
And Control

Objective.Most cases of necrotizing enterocolitis (NEC) are sporadic, but outbreaks in hospital settings suggest an infectious cause. Our neonatal intensive care unit (NICU) experienced an outbreak of methicillin-sensitiveStaphylococcus aureus(MSSA). We aimed to assess whether the enhancement of infection prevention and control measures would be associated with a reduction in the number of cases of NEC.Design.Retrospective chart review.Setting.A 24-bed, university-affiliated, inborn level 3 NICU.Participants.Infants of less than 30 weeks gestation or birth weight ≤ 1,500 g admitted to the NICU between January 2007 and December 2008 were considered at risk of NEC. All cases of NEC were reviewed.Interventions.Infection prevention and control measures, including hand hygiene education, were enhanced during the outbreak. Avoidance of overcapacity in the NICU was reinforced, environmental services (ES) measures were enhanced, and ES hours were increased.Results.Two hundred eighty-two at-risk infants were admitted during the study. Their gestational age and birth weight (mean ± SD) were 28.2 ± 2.7 weeks and 1,031 ± 290 g, respectively. The proportion of NEC was 18/110 (16.4%) before the outbreak, 1/54 (1.8%) during the outbreak, and 4/118 (3.4%) after the outbreak. After adjustment for gestational age, birth weight, gender, and singleton versus multiple births, the proportion was lower in the postoutbreak period than in the preoutbreak period (P< .002).Conclusion.Although this observational study cannot establish a causal relationship, there was a significant decrease in the incidence of NEC following implementation of enhanced infection prevention and control measures to manage an MSSA outbreak.Infect Control Hosp Epidemiol2012;33(1):29-33

scholarly journals Aerosol and environmental surface monitoring for SARS-CoV-2 RNA in a designated hospital for severe COVID-19 patients

2020 ◽  
Vol 148 ◽  
Author(s):  
Y. H. Li ◽  
Y. Z. Fan ◽  
L. Jiang ◽  
H. B. Wang
Keyword(s):  
Prevention And Control ◽  
Infection Prevention ◽  
Cross Infection ◽  
Infection Prevention And Control ◽  
Limited Information ◽  
Air Sampler ◽  
Environmental Surfaces ◽  
Environmental Surface ◽  
Control Procedures ◽  
And Control

Abstract There is limited information concerning the viral load of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in aerosols deposited on environmental surfaces and the effectiveness of infection prevention and control procedures on eliminating SARS-CoV-2 contamination in hospital settings. We examined the concentration of SARS-CoV-2 in aerosol samples and on environmental surfaces in a hospital designated for treating severe COVID-19 patients. Aerosol samples were collected by a microbial air sampler, and environmental surfaces were sampled using sterile premoistened swabs at multiple sites. Ninety surface swabs and 135 aerosol samples were collected. Only two swabs, sampled from the inside of a patient's mask, were positive for SARS-CoV-2 RNA. All other swabs and aerosol samples were negative for the virus. Our study indicated that strict implementation of infection prevention and control procedures was highly effective in eliminating aerosol and environmental borne SARS-CoV-2 RNA thereby reducing the risk of cross-infection in hospitals.

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