Outpatient Healthcare Personnel Knowledge and Attitudes Towards Infection Prevention Measures for Protection from Respiratory Infections

AbstractHealthcare personnel who perform invasive procedures and are living with HIV or hepatitis B have been required to self-notify the NC state health department since 1992. State coordinated review of HCP utilizes a panel of experts to evaluate transmission risk and recommend infection prevention measures. We describe how this practice balances HCP privacy and patient safety and health.

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Active involvement of patients and relatives improves subjective adherence to hygienic measures, especially selfreported hand hygiene: Results of the AHOI pilot study.

Antimicrobial Resistance and Infection Control ◽

10.1186/s13756-019-0648-6 ◽

2019 ◽

Vol 8 (1) ◽

Author(s):

Tillmann Görig ◽

Kathleen Dittmann ◽

Axel Kramer ◽

Claus-Dieter Heidecke ◽

Stephan Diedrich ◽

...

Keyword(s):

Pilot Study ◽

Infection Control ◽

Infection Prevention ◽

Patient Survey ◽

Three Dimensions ◽

Healthcare Personnel ◽

Prevention Measures ◽

Post Intervention ◽

Active Involvement ◽

Hygienic Measures

Abstract Background The prevention of nosocomial infections requires participation from the patients themselves. In the past, however, patients have been apprehensive to point out hygiene-relevant behaviour to the personnel. In the project AHOI, the possibilities of active patient involvement in infection prevention are identified, tested and realized. The goal is a prevention strategy based upon three dimensions: “adherence”, “empowerment” and “acceptance”. “AHOI” stands for the “Activation of patients, persons in need of care and care givers for a Hygiene-conscious participatiOn in Infection control”. Results from the AHOI pilot study on the implementation of a multimodal intervention bundle are reported. Methods In 2017, a two-stage patient survey was conducted on two surgical wards for 14 weeks. In addition to the intervention bundle, acceptance, adherence and empowerment regarding individual hygiene behaviour and perception were evaluated. The bundle included an AHOI-welcome-box with an informational and entertaining brochure and supportive incentives. Furthermore, multiple visual materials like video presentations for patients’ bedside TV, posters and visual reminders in the patients’ bedrooms and sanitary facilities were installed. Results 179 respondents were surveyed at admission, 139 at discharge and 133 at both time points. Almost all respondents wanted to contribute to infection control. The AHOI project was well accepted by patients. Two-thirds wanted to be more involved. More than a third expected a negative response from staff after pointing out hygiene deficiencies. Four respondents observed a deficiency in hygiene with healthcare personnel and reported a very positive reaction once this was communicated to the personnel. More than four-fifths of the respondents felt well integrated and adequately informed post intervention. The feeling of active involvement correlated significantly with subjective participation and adherence to hygienic measures, especially self-reported hand disinfection. Conclusion The results demonstrated that the required inclusion of patients in infection control is possible with AHOI. Active involvement of patients and relatives is associated with improvements in adherence to infection prevention measures.

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1205. Healthcare Personnel Knowledge, Attitudes, and Beliefs Towards Infection Prevention and Control Measures for Protection from Respiratory Infections

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.1068 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S433-S433

Author(s):

Mary T Bessesen ◽

Lewis Radonovich ◽

Susan M Rattigan ◽

Derek Cummings ◽

Maria C Rodriguez-Barradas ◽

...

Keyword(s):

Clinical Trial ◽

Prevention And Control ◽

Infection Prevention ◽

Healthcare Personnel ◽

Infection Prevention And Control ◽

Attitudes And Beliefs ◽

Knowledge And Attitudes ◽

N95 Respirators ◽

And Control ◽

Over Time

Abstract Background Healthcare personnel (HCP) knowledge and attitudes toward Infection Prevention and Control (IPC) measures are important determinants of practices that can protect them from acquisition of infectious diseases from patients. We aimed to describe HCP knowledge and attitudes concerning IPC measures over time in the context of a clinical trial. Methods ResPECT was a multi-center, multi-season cluster randomized clinical trial designed to compare the effectiveness of medical masks (MM) and N95 respirators (N95) for preventing acute respiratory illnesses in HCP employed in outpatient clinical settings. At the beginning of each respiratory virus season, participants completed a survey instrument to measure IPC knowledge. At the beginning and end of each season participants completed a survey to assess attitudes and beliefs about IPC measures, especially MM and N95. Results A pre-study and post-study survey pair was available for 88.1% of participant seasons. There were no significant differences in demographic variables or job assignment between survey respondents and nonrespondents for each participant season. Participants correctly identified 59.8% to 63.4% of IPC measures that should be used by HCP when exposed to patients with symptoms of acute respiratory illness, or at high risk of infection. There was modest improvement in the knowledge score over time among providers who participated for multiple years in the study. In the first pre-study survey of IPC attitudes and beliefs, 88.5% and 87.9% of participants identified at least one reason to avoid using either MM and N95, respectively (Figure 1). At the post-season survey, the proportion of participants reporting a reason to avoid MM fell to 39.6% (IRR for pre- vs. post-season 0.15, 95% CI 0.13–0.17) and 53.6% reported a reason to avoid N95 (IRR 0.57, 95% CI 0.51–0.66). Conclusion HCPknowledge of IPC precautions was poor, suggesting a need for better IPC education and accountability in the outpatient setting. When given incentives to comply with processes toward which they had negative attitudes at baseline, HCP realized that medical masks and N95 respirators were comfortable enough to wear for patient encounters and interfered with their work processes less than expected. Disclosures Trish M. Perl, MD; MSc, 7–11: Advisory Board; medimmune: Research Grant.

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Experience of patients diagnosed as asymptomatic COVID-19 after dental treatment

Maxillofacial Plastic and Reconstructive Surgery ◽

10.1186/s40902-021-00316-4 ◽

2021 ◽

Vol 43 (1) ◽

Author(s):

Ju-Yeon Seo ◽

Sung-Tak Lee ◽

So-Young Choi ◽

Jin-Wook Kim ◽

Tae-Geon Kwon

Keyword(s):

Infection Prevention ◽

Dental Treatment ◽

Close Contact ◽

Secondary Infection ◽

Maxillofacial Surgery ◽

Healthcare Personnel ◽

Oral And Maxillofacial Surgery ◽

Prevention Measures ◽

Case Presentation ◽

The Impact

Abstract Background The potential risk of coronavirus disease 2019 (COVID-19) transmission from asymptomatic COVID-19 patients is a concern in dental practice. However, the impact of this risk is not well documented to date. This report describes our dental clinical experience with patients who did not exhibit symptoms of COVID-19 but were later confirmed as positive for COVID-19. Case presentation Of the 149,149 patients who visited the outpatient clinic of KNUDH and the 3291 patients who visited the Oral and Maxillofacial Surgery Clinic of KNUH, 3 were later confirmed as having COVID-1 between 1 February 2020 and 28 February 2021. Owing to close contact with these patients during their treatments, 46 dental and medical staff had to undergo quarantine from the date of the patients’ confirmation of COVID-19 infection. Conclusion The presented cases showed the potential existence of asymptomatic COVID-19 patients after dental treatment with aerosol-generating procedures. Clinicians should be aware of the infection prevention measures and try to protect healthcare personnel from secondary infection of COVID-19 during dental treatments.

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Local hospital experience of emergency management in the response to SARS (Preprint)

10.2196/preprints.20287 ◽

2020 ◽

Author(s):

Ying Yan

Keyword(s):

Emergency Management ◽

Infection Prevention ◽

Public Health Emergency ◽

The Novel ◽

Prevention Measures ◽

Hospital Emergency ◽

Local Hospital ◽

Referral Network ◽

Novel Coronavirus ◽

Hospital Transmission

UNSTRUCTURED The ongoing outbreak of SARS-CoV-2 infection was first identified in Wuhan, China at the late of 2019. Following the acceleration of the novel coronavirus spreading, person-person transmissions in family residences, hospitals and other public environments have led to a major public hazard in China. Currently, the SARS-CoV-2 outbreak has been further developed into a public health emergency of international concern. In response to an occurring pandemic, hospitals need an emergency strategy and plan to manage their space, staff, and other essential resources, therefore, to provide optimum care to patients involved. In addition, infection prevention measures urgently need to be implemented to reduce in-hospital transmission and avoid the occurrence of virus super-spreading. For hospitals without capacity to manage severe patients, a referral network is often needed. We present our successful field experience regarding hospital emergency management and local hospitals network model in response to SARS-CoV-2 emerging epidemic.

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Legal Requirements for Infection Prevention and Control Training Among Healthcare Personnel

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.558 ◽

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

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Universal Masking to Control Healthcare-Associated Transmission of SARS-CoV-2

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2021.127 ◽

2021 ◽

pp. 1-24

Author(s):

Eliza R. Thompson ◽

Faith S. Williams ◽

Pat A. Giacin ◽

Shay Drummond ◽

Eric Brown ◽

...

Keyword(s):

Large Scale ◽

Infection Prevention ◽

Index Patient ◽

Field Investigation ◽

Point Prevalence ◽

Control Measures ◽

Prevention Measures ◽

Infection Control Measures ◽

Va Health Care System ◽

Healthcare Associated

Abstract Objective: To assess extent of a healthcare-associated outbreak of SARS-CoV-2 and evaluate effectiveness of infection control measures, including universal masking Design: Outbreak investigation including 4 large-scale point-prevalence surveys Setting: Integrated VA Health Care System with 2 facilities and 330 beds Participants: Index patient and 250 exposed patients and staff Methods: We identified exposed patients and staff and classified them as probable and confirmed cases based on symptoms and testing. We performed a field investigation and assessment of patient and staff interactions to develop probable transmission routes. Infection prevention interventions implemented included droplet and contact precautions, employee quarantine, and universal masking with medical and cloth facemasks. Four point-prevalence surveys of patient and staff subsets were conducted using real-time reverse-transcriptase polymerase chain reaction for SARS-CoV-2. Results: Among 250 potentially exposed patients and staff, 14 confirmed cases of Covid-19 were identified. Patient roommates and staff with prolonged patient contact were most likely to be infected. The last potential date of transmission from staff to patient was day 22, the day universal masking was implemented. Subsequent point-prevalence surveys in 126 patients and 234 staff identified 0 patient cases and 5 staff cases of Covid-19, without evidence of healthcare-associated transmission. Conclusions: Universal masking with medical facemasks was effective in preventing further spread of SARS-CoV-2 in our facility in conjunction with other traditional infection prevention measures.

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The impact of a multimodel approach to designing a new orthopedic department

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.1345 ◽

2020 ◽

pp. 1-6

Author(s):

Elad Keren ◽

Abraham Borer ◽

Lior Nesher ◽

Tali Shafat ◽

Rivka Yosipovich ◽

...

Keyword(s):

Hand Hygiene ◽

Antibiotic Stewardship ◽

Infection Prevention ◽

Tertiary Care ◽

Surgical Site Infections ◽

Antibiotic Use ◽

Prevention Measures ◽

Orthopedic Department ◽

Before And After ◽

The Impact

Abstract Objective: To determine whether a multifaceted approach effectively influenced antibiotic use in an orthopedics department. Design: Retrospective cohort study comparing the readmission rate and antibiotic use before and after an intervention. Setting: A 1,000-bed, tertiary-care, university hospital. Patients: Adult patients admitted to the orthopedics department between January 2015 and December 2018. Methods: During the preintervention period (2015–2016), 1 general orthopedic department was in operation. In the postintervention period (2017–2018), 2 separate departments were created: one designated for elective “clean” surgeries and another that included a “complicated wound” unit. A multifaceted strategy including infection prevention measures and introducing antibiotic stewardship practices was implemented. Admission rates, hand hygiene practice compliance, surgical site infections, and antibiotic treatment before versus after the intervention were analyzed. Results: The number of admissions and hospitalization days in the 2 periods did not change. Seven-day readmissions per annual quarter decreased significantly from the preintervention period (median, 7 days; interquartile range [IQR], 6–9) to the postintervention period (median, 4 days; IQR, 2–7; P = .038). Hand hygiene compliance increased and surgical site infections decreased in the postintervention period. Although total antibiotic use was not reduced, there was a significant change in the breakdown of the different antibiotic classes used before and after the intervention: increased use of narrow-spectrum β-lactams (P < .001) and decreased use of β-lactamase inhibitors (P < .001), third-generation cephalosporins (P = .044), and clindamycin (P < .001). Conclusions: Restructuring the orthopedics department facilitated better infection prevention measures accompanied by antibiotic stewardship implementation, resulting in a decreased use of broad-spectrum antibiotics and a significant reduction in readmission rates.

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

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.700 ◽

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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Impact of joint management of a COVID-19 mother and her newborn on the virus transmission: a case report

Virology Journal ◽

10.1186/s12985-021-01598-w ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Maria Chiara De Nardo ◽

Anna Rita Bellomo ◽

Francesca Perfetti ◽

Francesco Antonino Battaglia ◽

Miriam Lichtner ◽

...

Keyword(s):

Infection Prevention ◽

Virus Transmission ◽

The Novel ◽

Transplacental Transmission ◽

Prevention Measures ◽

Infected Mother ◽

Case Presentation ◽

Joint Management ◽

Healthy Neonate

Abstract Background Since last year, COVID-19, the disease caused by the novel Sars-Cov-2 virus, has been globally spread to all the world. COVID-19 infection among pregnant women has been described. However, transplacental transmission of Sars-Cov-2 virus from infected mother to the newborn is not yet established. The appropriate management of infants born to mothers with confirmed or suspected COVID-19 and the start of early breastfeeding are being debated. Case presentation We report a case of the joint management of a healthy neonate with his mother tested positive for Covid-19 before the delivery and throughout neonatal follow-up. The infection transmission from the mother to her baby is not described, even after a long period of contact between them and breastfeeding. Conclusion It may consider an appropriate practice to keep mother and her newborn infant together in order to facilitate their contact and to encourage breastfeeding, although integration with infection prevention measures is needed.

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