High risk procedures and respiratory infections in hospital health care workers – quantifying the risk

Background: Theoretically, health care workers (HCW) are at increased risk of getting infected with COVID-19 compared to the general population. Limited data exists regarding the actual incidence of COVID-19 infection amongst the high risk and low risk HCW of the same hospital. We present an audit from our tertiary cancer care centre comparing the COVID-19 infection rate between the high risk and low risk HCW, all of whom had been provided with adequate protective measures and health education.Methods: This is a retrospective observational study from 01 April 2020 to 30 September 2020, in which all the 970 HCW of Advanced Centre for Treatment, Research and Education in Cancer were divided into high risk and low risk groups. High risk HCW included all the medical and non-medical staff directly involved with the care of COVID-19 patients, and rest were low risk HCW. Adequate protective measures and classes for infection prevention were provided to all the HCW. We calculated the incidence of COVID-19 infection in both these groups based on the positive real time-polymerase chain reaction (RT-PCR) result and also looked for any significant difference in incidence between these two groups.Results: The incidence of COVID-19 infection amongst the high risk HCW was 13% and that of low risk HCW was 14%.Conclusions: We found no significant difference in COVID-19 infection between the high risk and low risk HCW. Thus, along with protective measures, behavior modifications induced by working in high risk areas, prevented the high risk HCW from getting increased COVID-19 infection compared to the low risk HCW.

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Utilization of an Orthopedic Hood as Personal Protective Equipment for Intubation of Coronavirus Patients: a Brief Technical Report

Geriatric Orthopaedic Surgery & Rehabilitation ◽

10.1177/2151459320930554 ◽

2020 ◽

Vol 11 ◽

pp. 215145932093055 ◽

Cited By ~ 2

Author(s):

Timothy T. Wills ◽

Wilhelm A. Zuelzer ◽

Bryant W. Tran

Keyword(s):

Health Care ◽

High Risk ◽

Endotracheal Intubation ◽

Health Care Workers ◽

Personal Protective Equipment ◽

Ventilation System ◽

The United States ◽

Protective Equipment ◽

Care Workers ◽

Technical Report

Background: The novel coronavirus disease (COVID-19) has afflicted millions of people worldwide since its first case was reported in December 2019. Personal protective equipment (PPE) has been tailored accordingly, but as of April 2020, close to 10 000 health care workers in the United States have contracted COVID-19 despite wearing recommended PPE. As such, standard guidelines for PPE may be inadequate for the health care worker performing high-risk aerosolizing procedures such as endotracheal intubation. In this brief technical report, we describe the integration of an orthopedic hood cover as an item for full barrier protection against COVID-19 transmission. Technical Description: The Coronavirus Airway Task Force at Virginia Commonwealth University Medical Center approved this initiative and went live with the full barrier suit during the last week of March 2020. The PPE described in this report includes a Stryker T4 Hood, normally used in conjunction with the Stryker Steri-Shield T4 Helmet. Instead of the helmet, the hood is secured to the head via a baseball cap and binder clip. This head covering apparatus is to be used as an accessory to other PPE items that include an N95 mask, waterproof gown, and disposable gloves. The motor ventilation system is not used in order to prevent airborne viral entry into the hood. Discussion: An advantage of the full barrier suit is an additional layer of droplet protection during intubation. The most notable disadvantage is the absence of a ventilation system within the hood covering. Conclusion: Modification of existing PPE may provide protection for health care workers during high-risk aerosolizing procedures such as endotracheal intubation. Although the integration of this medical equipment meets the immediate needs of an escalating crisis, further innovation is on the horizon. More research is needed to confirm the safety of modified PPE.

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Evaluation of Penetrating Stab Injuries in Health Care Workers in High-Risk Units of a Training and Research Hospital

Istanbul Cardiovascular Research Journal ◽

10.5222/icr.2015.041 ◽

2016 ◽

Author(s):

Sevda Türen ◽

Özlem Yakın ◽

Efsun Çağlar ◽

Necibe Uzun Morgül ◽

Filiz Çetin ◽

...

Keyword(s):

Health Care ◽

High Risk ◽

Health Care Workers ◽

Research Hospital ◽

Care Workers ◽

Training And Research ◽

Stab Injuries

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A Study to Evaluate the effectiveness of Planned Teaching Programme regarding knowledge on identification of High Risk Pregnancy among Health Care Workers

Asian Journal of Nursing Education and Research ◽

10.5958/2349-2996.2019.00011.9 ◽

2019 ◽

Vol 9 (1) ◽

pp. 59

Author(s):

P Vadivukkarasi Ramanadin ◽

Tripal Chaudhari ◽

Bhavisha Sujeeta ◽

Heena Christulas Jyoti ◽

Churchlin Sonlin ◽

...

Keyword(s):

Health Care ◽

High Risk ◽

Health Care Workers ◽

High Risk Pregnancy ◽

Teaching Programme ◽

Risk Pregnancy ◽

Care Workers

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FluMob: Enabling Surveillance of Acute Respiratory Infections in Health-care Workers via Mobile Phones

Frontiers in Public Health ◽

10.3389/fpubh.2017.00049 ◽

2017 ◽

Vol 5 ◽

Cited By ~ 10

Author(s):

May Oo Lwin ◽

Chee Fu Yung ◽

Peiling Yap ◽

Karthikayen Jayasundar ◽

Anita Sheldenkar ◽

...

Keyword(s):

Health Care ◽

Mobile Phones ◽

Health Care Workers ◽

Respiratory Infections ◽

Acute Respiratory Infections ◽

Care Workers

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Development of an Objective Risk Stratification Tool to facilitate workplace assessments of healthcare workers when dealing with the CoViD-19 pandemic

10.1101/2020.05.05.20091967 ◽

2020 ◽

Cited By ~ 2

Author(s):

W David Strain ◽

Janusz Jankowski ◽

Angharad Davies ◽

Peter MB English ◽

Ellis Friedman ◽

...

Keyword(s):

Health Care ◽

High Risk ◽

Risk Stratification ◽

Health Care Workers ◽

Healthcare Workers ◽

List Type ◽

Care Workers ◽

Increased Risk ◽

Objective Risk ◽

Risk Stratification Tool

SummaryHealthcare workers have a greater exposure to individuals with confirmed SARS-novel coronavirus 2, and thus a higher probability of contracting coronavirus disease (CoViD)-19, than the general population. Employers have a duty of care to minimise the risk for their employees. Several bodies including the Faculty of Occupational Medicine, NHS Employers, and Public Health England have published a requirement to perform risk assessments for all health care workers, however, with the absence of an objective risk stratification tool, comparing assessments between individuals is difficult if not impossible. Using published data, we explored the predictive role of basic demographics such as age, sex, ethnicity and comorbidities in order to establish an objective risk stratification tool that could help risk allocate duties to health care workers. We developed an objective risk stratification tool using a Caucasian female <50years of age with no comorbidities as a reference. Each point allocated to risk factors was associated with an approximate doubling in risk. This tool was then validated against the primary care-based analysis. This tool provides objective support for employers when determining which healthcare workers should be allocated to high-risk vs. lower risk patient facing clinical duties or to remote supportive roles.Strengths and limitations of this studyThere is an increased risk of mortality in the clinical workforce due to the effects of CoViD-19.This manuscript outlines a simple risk stratification tool that helps to quantify an individual’s biological riskThis will assist team leaders when allocating roles within clinical departments.This tool does not incorporate other external factors, such as high-risk household members or those at higher risk of mental health issues, that may require additional consideration when allocating clinical duties in an appropriate clinical domain.This population-based analysis did not explain for the very high risk observed in BAME healthcare workers suggesting there are other issues at play that require addressing. BAME healthcare workers suggesting there are other issues at play that require addressing.

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Hepatitis B Virus Antibody Levels in High-Risk Health Care Workers

Hepatitis Monthly ◽

10.5812/kowsar.1735143x.1388 ◽

2011 ◽

Vol 11 (8) ◽

pp. 662-663 ◽

Cited By ~ 2

Author(s):

Esmaeil Mohammad Nejad ◽

Sirous Jafari ◽

Mahmood Mahmoodi ◽

Jamaloddin Begjani ◽

Seyyedeh Roghayyeh Ehsani ◽

...

Keyword(s):

Health Care ◽

Hepatitis B Virus ◽

High Risk ◽

Hepatitis B ◽

Health Care Workers ◽

Virus Antibody ◽

Care Workers ◽

B Virus ◽

Antibody Levels

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Response by Endodontists to the SARS-CoV-2 (COVID−19) Pandemic: An International Survey

Frontiers in Dental Medicine ◽

10.3389/fdmed.2020.617440 ◽

2021 ◽

Vol 1 ◽

Author(s):

Johnah C. Galicia ◽

Rahma Mungia ◽

Melanie V. Taverna ◽

Marissa J. Mendoza ◽

Carlos Estrela ◽

...

Keyword(s):

Health Care ◽

High Risk ◽

Health Care Workers ◽

Clinical Care ◽

Treatment Strategies ◽

International Survey ◽

Care Protocol ◽

Care Workers ◽

International Data ◽

The Government

As SARS-CoV-2 continues to wreak havoc, health care workers are on the front lines to protect our communities. Dentists, particularly endodontists who manage dental emergencies, are engaged in high risk procedures that necessitate the modification of their treatment strategies in order to protect themselves, their staff and their patients from exposure to SARS-CoV-2. This study gathered international data from 448 endodontists to describe their awareness, their clinical care modifications, their strategies for re-opening and their reflection on the effects of the pandemic on their lives. Most endodontic practitioners (78%, n = 350) provided but limited their treatments to emergency care during the government-mandated shutdowns. They agreed with their local government's actions more than that of the national government, screened their patients for symptoms prior to treatment and changed their clinical care protocol to mitigate the spread of the virus. The pandemic has impacted their income, their ability to retain staff, and their financial and personal outlook in life.

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Snapshot Impact of COVID-19 on Mental Wellness in Nonphysician Otolaryngology Health Care Workers: A National Study

OTO Open ◽

10.1177/2473974x20948835 ◽

2020 ◽

Vol 4 (3) ◽

pp. 2473974X2094883 ◽

Cited By ~ 1

Author(s):

Aman Prasad ◽

Alyssa M. Civantos ◽

Yasmeen Byrnes ◽

Kevin Chorath ◽

Seerat Poonia ◽

...

Keyword(s):

Mental Health ◽

United States ◽

Health Care ◽

High Risk ◽

Health Care Workers ◽

The United States ◽

Assessment Tools ◽

Care Providers ◽

Event Scale ◽

Care Workers

Objective Nonphysician health care workers are involved in high-risk patient care during the COVID-19 pandemic, placing them at high risk of mental health burden. The mental health impact of COVID-19 in this crucial population has not been studied thus far. Thus, the objective of this study is to assess the psychosocial well-being of these providers. Study Design National cross-sectional online survey (no control group). Setting Academic otolaryngology programs in the United States. Subjects and Methods We distributed a survey to nonphysician health care workers in otolaryngology departments across the United States. The survey incorporated a variety of validated mental health assessment tools to measure participant burnout (Mini-Z assessment), anxiety (Generalized Anxiety Disorder–7), distress (Impact of Event Scale), and depression (Patient Health Questionnaire–2). Multivariable logistic regression analysis was performed to determine predictive factors associated with these mental health outcomes. Results We received 347 survey responses: 248 (71.5%) nurses, 63 (18.2%) administrative staff, and 36 (10.4%) advanced practice providers. A total of 104 (30.0%) respondents reported symptoms of burnout; 241 (69.5%), symptoms of anxiety; 292 (84.1%), symptoms of at least mild distress; and 79 (22.8%), symptoms of depression. Upon further analysis, development of these symptoms was associated with factors such as occupation, practice setting, and case load. Conclusion Frontline otolaryngology health care providers exhibit high rates of mental health complications, particularly anxiety and distress, in the wake of COVID-19. Adequate support systems must be put into place to address these issues.

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