scholarly journals The Impact of COVID-19 on Patient Safety: A Survey of Acute-Care Registered Nurses in New Jersey

2021 ◽  
Vol 1 (S1) ◽  
pp. s54-s55
Author(s):  
Monika Pogorzelska-Maziarz ◽  
Mary Lou Manning ◽  
Angela Gerolamo ◽  
Mary Johansen ◽  
Irina Grafova ◽  
...  

Background: As the world grapples with the pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), it is important to consider the full impact of coronavirus disease 2019 (COVID-19) on healthcare delivery. Evidence from outbreaks of novel H1N1 and Ebola indicates that response to these types of outbreaks requires extraordinary resources, which are diverted from routine infection prevention and control activities. However, little is known about the impact of COVID-19 on adherence to patient safety protocols in hospitals, including infection prevention and control activities. We have described the reports of acute-care registered nurses (RNs) in adhering to patient safety protocols while delivering care to COVID-19 patients. Methods: In October 2020, we conducted a cross-sectional electronic survey of all active RNs in the state of New Jersey who provided direct patient care in a New Jersey hospital in an emergency or adult inpatient unit during the onset of the COVID-19 pandemic. Results: More than 3,027 RNs participated in the survey, for a 15% response rate based on number of eligible RNs. Moreover, 15% of respondents reported that they tested positive for COVID-19 during the initial peak of COVID-19 in New Jersey (March–June 2020). Most RNs reported that the number of patients they were assigned during the first peak of the pandemic affected their ability to adhere to patient safety protocols (eg, deep-vein thrombosis screening, central-line bundles, pressure ulcer prevention). In open-ended responses, they shared that being understaffed, the extra time it took for downing and doffing of PPE, the lack of access to ancillary staff (ie nursing assistants, runners), and the need to cluster care affected the quality of care. A nurse working in the intensive care unit (ICU) lamented, “We were sometimes given 4–5 ICU patients who were very sick and required a lot of care. Shortcuts had to be taken to prioritize the most important needs. Sometimes IVs remained longer than desired. Foleys remained in longer. To avoid PPE shortages, we didn’t go into the rooms nearly as much as we normally would, [and] things got missed.” Feelings of being overwhelmed and helpless permeated the nurses’ comments. Conclusions: When caring for COVID-19 patients, frontline nurses struggled with adherence to necessary patient safety protocols, which ultimately disrupted care delivery. Future research should quantify the extent to which the COVID-19 pandemic affected care delivery, including adherence to patient safety protocols among frontline providers.Funding: NoDisclosures: None

2020 ◽  
Author(s):  
Denise van Hout ◽  
Paul Hutchinson ◽  
Marta Wanat ◽  
Caitlin Pilbeam ◽  
Herman Goossens ◽  
...  

ABSTRACTBackgroundWorking under pandemic conditions exposes health care workers (HCWs) to infection risk and psychological strain. Protecting the physical and psychological health of HCWs is a key priority. This study assessed the perceptions of European hospital HCWs of local infection prevention and control (IPC) procedures during the COVID-19 pandemic and the impact on their emotional wellbeing.MethodsWe performed two rounds of an international cross-sectional survey, between 31 March and 17 April 2020 via existing research networks (round 1), and between 14 May and 31 August 2020 via online convenience sampling (round 2). Main outcome measures were (1) behavioural determinants of HCW adherence with IPC procedures, (2) WHO-5 Well-Being Index, a validated scale of 0-100 reflecting emotional wellbeing. The WHO-5 was interpreted as a score below or above 50 points, a cut-off score used in previous literature to screen for depression.Results2,289 HCWs (round 1: n=190, round 2: n=2,099) from 40 countries in Europe participated. Mean age of respondents was 42 (±11) years, 66% were female, 47% and 39% were medical doctors and nurses, respectively. 74% (n=1699) of HCWs were directly treating patients with COVID-19, of which 32% (n=527) reported they were fearful of caring for these patients. HCWs reported high levels of concern about COVID-19 infection risk to themselves (71%) and their family (82%) as a result of their job. 40% of HCWs considered that getting infected with COVID-19 was not within their control. This was more common among junior than senior HCWs (46% versus 38%, P value <.01). Sufficient COVID-19-specific IPC training, confidence in PPE use and institutional trust were positively associated with the feeling that becoming infected with COVID-19 was within their control. Female HCWs were more likely than males to report a WHO-5 score below 50 points (aOR 1.5 (95% confidence interval (CI) 1.2-1.8).ConclusionsIn Europe, the COVID-19 pandemic has had a differential impact on those providing direct COVID-19 patient care, junior staff and women. Health facilities must be aware of these differential impacts, build trust and provide tailored support for this vital workforce during the current COVID-19 pandemic.


2021 ◽  
Vol 3 (3) ◽  
pp. 379-386
Author(s):  
Candra Dewi Rahayu ◽  
Diah Fitri Purwaningsih ◽  
Ika Silvitasari

The hospital is the health service structure that plays the most prominent role with the Covid-19 pandemic.The nursing profession is still required to provide quality nursing care to Covid-19 patients, as well as to other patients so that the provision of nursing care must be in accordance with the procedures and management of patients with infectious diseases accurately and correctly and use Personal Protection Equipment in accordance with standard. Infection prevention and control during the pandemic is very important for patients and health workers to minimize the occurrence of nosocomial infections during hospital care. This review aims to determine the development of infection prevention and control program in the provision of nursing care during the Covid-19 pandemic. The research method with a review was carried out by searching for articles related to patient safety in providing Covid-19 nursing care. Literatures search were carried out in December 2020 - January 2021 through PubMed, Sciencedirec, google scholar, government policy then entered the online database list by entering keywords, namely patient safety, nursing care, Covid-19. Selected journals were based on inclusion and exclusion criteria through a critical assessment process with CASP to assess the quality of articles. The results of the critical appraisal obtained six articles that match the inclusion criteria with a minimum appraisal score of 85 in good categories which are then carried out by analysts. The results of the research by reviewing 6 articles show that prevention and control of patients safety in providing nursing care during a pandemic can be developed through nursing care management by using summarized checklists, patient safety-based nursing care service system, infection prevention and control during the pandemic and inclusive leadership. Nursing care management, patient safety, infection prevention and control and an inclusive leadership style are the development methods that can be used for the prevention and control of Covid-19.


2019 ◽  
Vol 9 (10) ◽  
pp. 59 ◽  
Author(s):  
Thoraya Abdelaziz ◽  
Rawhia Dogham ◽  
Nermine Elcockany

Undergraduate nursing education plays a vital role in acquiring the necessary competency for patient safety. Infection prevention and control is a very critical topic for providing patient safety so, undergraduate and graduate nursing students should be competent in infection prevention and control. The aim of this study was to measure the undergraduate nursing program effectiveness in improving knowledge and practice of infection prevention and control of internship nursing students and to identify their learning needs. A descriptive research design was used. Students were selected using convenience sampling which included 400 internship nurses. Data was collected using a self-reported questionnaire. The results of the current study displayed that more than half (59.5%) of the intern nurses had poor knowledge and also 43.2% of them had poor practice.  In addition, it was found that more than half of them reported that infection control program is neither irrelevant nor meaningful, and 48.5% of the students suggested that participation in infection prevention and control training is most important for the improvement of nursing program. This study concluded that infection prevention and control topics in undergraduate nursing education may be insufficient and need to be updated, as well as the need for reviewing the intended learning outcomes of nursing program to ensure the addition and implementation of infection control guidelines in all undergraduate in the last academic year of nursing program as well as internship. The students also are in need for continued training and education regarding guidelines of infection prevention and control practice.


2018 ◽  
Vol 19 (6) ◽  
pp. 287-293
Author(s):  
Ogbaini-Emovon Ephraim ◽  
Sneh Cyrus ◽  
Pajibo Myer ◽  
Abah Steve

Background: Supportive supervision of infection prevention and control (IPC) practices was one of a range of interventions employed at the county level in the control of the world’s most deadly Ebola virus disease outbreak that affected Liberia during 2013–2016. Methods: Datasets generated from four consecutive assessment visits to 25 health facilities in Maryland County, in Liberia, were analysed. Information on IPC practices was obtained by interview, direct observation and completion of a standardised assessment tool. For each of the IPC fields assessed, a score < 50% was graded poor, 50–75% as fair, while > 75% was rated as good. Results: Before the intervention, the first assessment (baseline) indicated that the majority of the health facilities scored low in terms of isolation facilities, IPC administration, supply and equipment, personnel and staffing, triage and waste management. Following the application of supportive supervision and monitoring, all the facilities recorded moderate to good performance in all the fields during the fourth round of assessment, except for isolation facilities, which scored low. Conclusion: Supportive supervision and monitoring of healthcare facilities appeared to have contributed to the improvement in IPC standards and compliance during the Ebola outbreak as demonstrated in this small-scale study and should be sustained as a core component of IPC programs, particularly in prolonged outbreak situations.


PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245212
Author(s):  
Raad Fadaak ◽  
Jan M. Davies ◽  
Marlot Johanna Blaak ◽  
John Conly ◽  
Joanne Haslock ◽  
...  

Background In response to the Coronavirus disease-19 (COVID-19) pandemic, in-patient units in hospitals around the world have altered their patient care routines and Infection Prevention and Control (IPC) practices. Our interdisciplinary team of applied Human Factors (HF), ethnography, and IPC experts assisted one Unit, normally serving general surgical and orthopedic patients, as it rapidly converted to deliver COVID-19-specific care. This paper describes the conversion experience of the Unit, and outlines broader lessons for other acute care teams faced with similar issues. Methods We deployed walkthroughs, simulations, and ethnography to identify important safety gaps in care delivery processes on the Unit. These interventions were undertaken using interdisciplinary theories of implementation that combined systems-level HF perspectives, ethnographic approaches, and individual-level IPC perspectives. Timely recommendations were developed and delivered to Unit staff for feedback and implementation. Results We describe three interventions on the Unit: 1) the de-cluttering and re-organization of personal protective equipment (PPE); 2) the reconfiguring of designated ‘dirty’ tray tables and supplies; and 3) the redesign of handling pathways for ‘dirty’ linens and laundry. Each of these interventions was implemented to varying degrees, but all contributed to discussions of safety and IPC implementation that extended beyond the Unit and into the operations of the broader hospital. Conclusions Leveraging our team’s interdisciplinary expertise and blended approaches to implementation, the interventions assisted in the Unit’s rapid conversion towards providing COVID-19-specific care. The deployment and implementation of the interventions highlight the potential of collaboration between HF, ethnography, and IPC experts to support frontline healthcare delivery under pandemic conditions in an effort to minimize nosocomial transmission potential in the acute healthcare setting.


2018 ◽  
Vol 19 (6) ◽  
pp. 302-309
Author(s):  
Sue Millward

Background: The Director of Infection Prevention and Control (DIPC) role was introduced into the UK in 2003 to address the need for effective leadership within Infection Prevention (IP). The role was embedded in English legislation in 2008. In one Independent healthcare organisation (with 31 acute hospitals spread geographically across the UK), the DIPC role is held by the hospital matron (known as Director of Nursing in the NHS), who influence resource allocation and ensure infection prevention is prioritised. A knowledge gap in microbiology, standard precautions and infection prevention regulatory requirements was identified and as there was no educational provision for this role, an accredited programme was developed. Twenty-five matrons completed the DIPC programme. Aims: Evaluate the impact of a DIPC educational programme on the delivery of IP services. Methodology: A post-course qualitative retrospective survey using open-ended questions was used to collect data from DIPCs who had completed the programme. Inductive thematic and content analysis methods were used to identify key themes from survey responses. Results: Out of 20 DIPCs, 16 completed the survey. Key findings included improvements in knowledge related to microbiology, IP and regulatory requirements of the DIPC role. DIPCs reported changes to service delivery including appointment of six IP nurses, improved surveillance processes, reduced infections and improved cleanliness standards. This small study demonstrates the impact of an educational programme for DIPCs who felt more empowered to manage the IP services effectively, resulting in improved patient safety through reduced infections.


2018 ◽  
Vol 71 (3) ◽  
pp. 1170-1177 ◽  
Author(s):  
Andréa Mara Bernardes da Silva ◽  
Lucas Lazarini Bim ◽  
Felipe Lazarini Bim ◽  
Alvaro Francisco Lopes Sousa ◽  
Pedro Castania Amadio Domingues ◽  
...  

ABSTRACT Objective: To analyze curricular integration between teaching of patient safety and good infection prevention and control practices. Method: Integrative review, designed to answer the question: “How does curricular integration of content about ‘patient safety teaching’ and content about ‘infection prevention and control practices’ occur in undergraduate courses in the health field?”. The following databases were searched for primary studies: CINAHL, LILACS, ScienceDirect, Web of Science, Scopus, Europe PMC and MEDLINE. Results: The final sample consisted of 13 studies. After content analysis, primary studies were grouped into two subject categories: “Innovative teaching practices” and “Curricular evaluation. Conclusion: Patient safety related to infection prevention and control practices is present in the curriculum of health undergraduate courses, but is not coordinated with other themes, is taught sporadically, and focuses mainly on hand hygiene.


2021 ◽  
Vol 1 (S1) ◽  
pp. s53-s54
Author(s):  
Mohammed Alsuhaibani ◽  
Takaaki Kobayashi ◽  
Stephanie Holley ◽  
Angie Dains ◽  
Oluchi Abosi ◽  
...  

Background: The COVID-19 pandemic has affected healthcare systems worldwide, but the impact on infection prevention and control (IPC) programs has not been fully evaluated. We assessed the impact of the COVID-19 pandemic on IPC consultation requests. Methods: The University of Iowa Hospitals & Clinics comprises an 811-bed hospital that admits >36,000 patients yearly and >200 outpatient clinics. Questions about IPC can be addressed to the Program of Hospital Epidemiology via e-mail, in person, or through our phone line. We routinely record date and time, call source, reason for the call, and estimated time to resolve questions for all phone line requests. We defined calls during 2018–2019 as the pre–COVID-19 period and calls from January to December 2020 as the COVID-19 period. Results: In total, 6,564 calls were recorded from 2018 to 2020. In the pre–COVID-19 period (2018–2019), we received a median of 71 calls per month (range, 50–119). The most frequent call sources were inpatient units (n = 902; 50%), department of public health (n = 357; 20%), laboratory (n = 171; 9%), and outpatient clinics (n = 120; 7%) (Figure 1). The most common call topics were isolation and precautions (n = 606; 42%), outside institutions requests (n = 324; 22%), environmental and construction (n = 148; 10%), and infection exposures (n = 149; 10%). The most frequent infection-related calls were about tuberculosis (17%), gram-negative organisms (14%), and influenza (9%). During the COVID-19 period, the median monthly call volume increased 500% to 368 per month (range, 149–829). Most (83%) were COVID-19 related. The median monthly number of COVID-19 calls was 302 (range, 45–674). The median monthly number of non–COVID-19 calls decreased to 56 (range, 36–155). The most frequent call sources were inpatient units (57%), outpatient clinics (16%), and the department of public health (5%). Most calls concerned isolation and precautions (50%) and COVID-19 testing (20%). The mean time required to respond to each question was 10 minutes (range, 2–720). The biggest surges in calls during the COVID-19 period were at the beginning of the pandemic (March 2020) and during the hospital peak COVID-19 census (November 2020). Conclusions: In addition to supporting a proactive COVID-19 response, our IPC program experienced a 500% increase in consultation requests. Planning for future bioemergencies should include creative strategies to provide additional resources to increase response capacity within IPC programs.Funding: NoDisclosures: None


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