scholarly journals Implementation of SHEA/CDC Outbreak Response Training Program Tools to Develop a Dedicated COVID-19 Hospital in Lucas County, Ohio

Author(s):  
Jennifer Hanrahan ◽  
Joel Kammeyer ◽  
Deana Sievert ◽  
Brenda Naylor ◽  
Sadik Khuder ◽  
...  

Abstract We describe a care delivery model in which one hospital in a larger health system was dedicated exclusively to treatment of COVID-19 patients. This allowed for rapid training, conservation of resources and promoted safety of healthcare workers, demonstrated by no healthcare worker exposures due to improper personal protective equipment use.

2016 ◽  
Vol 37 (11) ◽  
pp. 1323-1330 ◽  
Author(s):  
Elise M. Martin ◽  
Dana Russell ◽  
Zachary Rubin ◽  
Romney Humphries ◽  
Tristan R. Grogan ◽  
...  

OBJECTIVETo evaluate the impact of discontinuation of contact precautions (CP) for methicillin-resistantStaphylococcus aureus(MRSA) and vancomycin-resistantEnterococcus(VRE) and expansion of chlorhexidine gluconate (CHG) use on the health system.DESIGNRetrospective, nonrandomized, observational, quasi-experimental study.SETTINGTwo California hospitals.PARTICIPANTSInpatients.METHODSWe compared hospital-wide laboratory-identified clinical culture rates (as a marker of healthcare-associated infections) 1 year before and after routine CP for endemic MRSA and VRE were discontinued and CHG bathing was expanded to all units. Culture data from patients and cost data on material utilization were collected. Nursing time spent donning personal protective equipment was assessed and quantified using time-driven activity-based costing.RESULTSAverage positive culture rates before and after discontinuing CP were 0.40 and 0.32 cultures/100 admissions for MRSA (P=.09), and 0.48 and 0.40 cultures/100 admissions for VRE (P=.14). When combining isolation gown and CHG costs, the health system saved $643,776 in 1 year. Before the change, 28.5% intensive care unit and 19% medicine/surgery beds were on CP for MRSA/VRE. On the basis of average room entries and donning time, estimated nursing time spent donning personal protective equipment for MRSA/VRE before the change was 45,277 hours/year (estimated cost, $4.6 million).CONCLUSIONDiscontinuing routine CP for endemic MRSA and VRE did not result in increased rates of MRSA or VRE after 1 year. With cost savings on materials, decreased healthcare worker time, and no concomitant increase in possible infections, elimination of routine CP may add substantial value to inpatient care delivery.Infect Control Hosp Epidemiol2016;1–8


2020 ◽  
Vol 77 (23) ◽  
pp. 1986-1993 ◽  
Author(s):  
Autumn D Zuckerman ◽  
Pratish C Patel ◽  
Mark Sullivan ◽  
Amy Potts ◽  
Molly Knostman ◽  
...  

Abstract Purpose This report describes a health-system pharmacy’s response to a natural disaster while staff members simultaneously prepared for the coronavirus disease 2019 (COVID-19) pandemic. By detailing our experience, we hope to help other institutions that are current facing or could encounter similar crises. Summary In early March 2020, a tornado destroyed the health system’s warehouse for storage of most clinical supplies, including personal protective equipment and fluids. The pharmacy purchasing team collaborated with suppliers and manufacturers to recover losses and establish alternative storage areas. Days later, the pharmacy department was forced to address the impending COVID-19 pandemic. Key elements of the COVID-19 response included reducing the potential for virus exposure for patients and staff; overcoming challenges in sourcing of staff, personal protective equipment, and medications; and changing care delivery practices to maintain high-quality patient care while maximizing social distancing. The pharmacy department also created distance learning opportunities for 70 pharmacy students on rotations. After an initial plan, ongoing needs include adjustment in patient care activities if significant staff losses occur, when and how to resume clinical activities, and how to best utilize the resources accumulated. Elements of practice changes implemented to reduce COVID-19 threats to patients and pharmacy personnel have proven beneficial and will be further evaluated for potential continuation. Conclusion The pharmacy department’s efforts to respond to a natural disaster and unprecedented pandemic have proven successful to this point and have illuminated several lessons, including the necessity of cohesive department communication, staff flexibility, prioritization of teamwork, and external collaboration.


2021 ◽  
pp. 1-7
Author(s):  
Beatriz Simões Vala ◽  
Mariana Lopes Costa ◽  
Joana Aquino ◽  
Bilhota Xavier

<b><i>Introduction:</i></b> The novel coronavirus pandemic poses a challenge to healthcare systems’ balance. Since children apparently have milder disease courses, COVID-19 guidelines were not easily adapted to pediatrics. We intend to characterize how the national departments of pediatrics adapted to the pandemic at the beginning and describe the measures that were taken to protect healthcare workers. <b><i>Methods:</i></b> An unvalidated online questionnaire was sent to all departments of pediatrics directors of Portuguese public health system hospitals regarding course of actions taken between April and May 2020 to face the new coronavirus pandemic. Neonatology units were excluded. <b><i>Results:</i></b> Thirty-eight questionnaires were included (93% of public health system departments). All departments divided the pediatric emergency unit into non-COVID-19 and COVID-19 areas: 68% in different areas, 47% divided the same space with a physical barrier and 16% with a line on the floor. Healthcare workers were divided into non-COVID-19 and COVID-19 teams in 71% of the departments. Personal protective equipment mostly used in COVID-19 areas consisted of face shield/goggles (97%) and respirators (95%). Others wore surgical masks (8%). The main clinical criteria for testing were Direção-Geral da Saúde criteria (84%). Presential appointments were maintained in 68% of departments with selected follow-up (81%) and priority-first appointments (73%). <b><i>Discussion:</i></b> National departments of pediatrics faced the pandemic differently and measures taken in the emergency department were more similar. Personal protective equipment was adequate in all wards with occasional overuse, considering national and international guidelines.


2020 ◽  
Vol 8 (2) ◽  
pp. 97
Author(s):  
Connie CR Gan ◽  
Febi Dwirahmadi

INTRODUCTIONThe response to the COVID-19 pandemic is a tragic aberration gripping the world. As the disease evolves, uncertainty and fear of harm rise, which can significantly diminish community health and wellbeing. This article stresses the importance of public health preparedness in overcoming social and health risks associated with public panic.Since the COVID-19 outbreak began in late 2019, the numbers of people affected and fatalities continue to mount, causing panic and crippling vital economic and social activities. Authorities have failed to prevent inaccurate and misleading headlines that agitate the public and impinge on public communication. Fake news and rumors about magical products claiming to cure the virus abound. Additionally, people assumed emergency preparation meant stockpiling resources. Amid growing fears, consumers raided supermarkets and pharmacies for supplies, from masks to hygiene products, and people have fought over protective gear as tensions flared among anxious customers.When general panic starts driving political decision-making, public health professionals may be unable to implement strategies based on informed decisions. Researchers argue that government secrecy and non-transparency diminish people’s confidence and trust, creating panic (Wilson et al., 2007). Even naming the disease possibly triggered epidemic-related trauma and the ensuing public mistrust and disbelief of authorities; the panic has also sparked a wave of racial prejudice (Titanji, 2020). Although a series of emerging and re-emerging infectious diseases, from Avian flu to Zika virus, may have created more public awareness, whether leaders can translate this newfound awareness into meaningful policies and action is debatable.Globally, attention is growing on responses from state leaders, as some try to downplay the epidemic’s severity to maintain “business as usual”. In early March 2020, the Indonesian government was still in a state of denial and was attempting to convince the general public that the country was free from COVID-19 (Lindsey & Mann, 2020) Instead, currently confirmed cases are growing rapidly, suspected cases are far above the testing capacity, and case fatality is at an alarming rate.In contrast, several countries took drastic action by declaring travel restrictions and locking down cities. As an example, New Zealand decided to implement level-4 measures, with strict movement restrictions, not long after they confirmed their first case on 28 February 2020; they have recently begun a gradual exit from coronavirus lockdown (Knight, 2020).The public expects leaders to curb the spread of COVID-19 responsibly, appropriately, effectively, and proactively. Meanwhile, leaders are urging the public to stay calm and adopt new norms during this rapidly evolving situation. This crisis is not limited to any individual and requires cooperation rather than a unilateral response. DISCUSSIONHow to do this?A critical approach to pandemics is to ensure the preparedness of both healthcare capacity and public health systems (Jain, Duse, & Bausch, 2018). To respond to emergency needs—to have the capacity to treat rapidly increasing numbers of COVID-19 patients—it is important for each country to have existing policies and action plans for healthcare facilities to temporarily expand service capacity, cancel or postpone elective procedures, and engage in rapid intervention to conserve medical supplies, including personal protective equipment (Gan, Tseng, & Lee, 2020). Measures including recalling recently retired healthcare workers and providing drive-through services for chronic disease medications have been implemented to lessen pressures on hospitals (Wang, Ng, & Brook, 2020).While healthcare capacity is the ability to care for patients with COVID-19, the public health system aims to prevent people from being infected and mitigating the health risks associated with COVID-19. The public health system is important for strengthening community vigilance by promoting effective sanitation, a healthy lifestyle, and food safety, and preventing injuries, inequality, and violence. This involves not only healthcare professionals, but also well-planned strategies that consider various stakeholders’ perspectives and concerns (Glik, 2007). Despite the lockdown, we have seen healthcare workers and people in the community providing the basic essentials for those in need—from food, Personal Protective Equipment (PPE), mental health support, and evidence-based research communication, to virtual musical performances and concerts. Organizations in the virtual sphere, including WhatsApp (WhatsApp Inc, 2020) and TikTok, are partnering with health agencies to increase accessibility to health information.The best outbreak response is a collective response (Gille & Brall, 2020), which could effectively contain the disease and the panic caused by the disease. People naturally experience fear when dealing with a catastrophic event. This unprecedented threat triggered panic purchasing or falling for viral hoaxes, which reflects misconceptions about the problem, most likely because people lack trust in the measures taken (Heide, 2004), When designing and implementing public health measures, we must ensure we do not just acknowledge that, but actively engage relevant stakeholders. In an age of uncertainty, community solidarity and collective action are key to maintaining community vigilance against the crisis (Aldrich et al., 2015).


2021 ◽  
Vol 72 (1) ◽  
pp. 40-46
Author(s):  
Marina Ruxandra Oțelea ◽  
Dana Mateș ◽  
Agripina Rașcu

Abstract The current pandemic pointed toward a revision of the protection measures against infectious diseases. For any given new pathogen against which human species showed no immunity, isolation and personal protection equipment proved to reduce disease transmission. In medical settings, when there is inevitable contact with infected patients, these preventive measures have undoubtedly change the process of care delivery. The study aims to investigate the opinion of the healthcare workers about the utilization of the personal protective equipment after the pandemic stops. For this purpose, we conducted an online survey about changes related to the COVID-19 pandemic. For the healthcare workers, the survey also included several questions related to personal protective equipment. A total of 512 responders, doctors, and nurses answered to the survey. We performed comparisons between these two categories of personnel using the χ test. Overall, the results show that doctors are keener to follow the recommendations for the personal protective equipment in the future; there was a statistically significant difference (p<0.001) for the usage of gloves and masks while examining febrile patients, and for the handwashing after the examination of each patient. The type of service (outpatient or inpatient procedures) and direct contact with a COVID-19 patient were other factors to modulate the responses regarding using personal protective equipment in the future. The fact that 14.06% of the responders did not consider it necessary to wash hands after examining each patient underlines the urgent need for safety education in all healthcare workers and nurses.


Author(s):  
Nhan Phuc Thanh Nguyen ◽  
Duong Dinh Le ◽  
Robert Colebunders ◽  
Joseph Nelson Siewe Fodjo ◽  
Trung Dinh Tran ◽  
...  

Frontline healthcare workers (HCWs) involved in the COVID-19 response have a higher risk of experiencing psychosocial distress amidst the pandemic. Between July and September 2020, a second wave of the COVID-19 pandemic appeared in Vietnam with Da Nang city being the epicenter. During the outbreak, HCWs were quarantined within the health facilities in a bid to limit the spread of COVID-19 to their respective communities. Using the stress component of the 21-item Depression, Anxiety and Stress Scale (DASS-21), we assessed the level of stress among HCWs in Da Nang city. Between 30 August and 15 September 2020, 746 frontline HCWs were recruited to fill in an online structured questionnaire. Overall, 44.6% of participants experienced increased stress and 18.9% severe or extremely severe stress. In multivariable analysis, increased stress was associated with longer working hours (OR = 1.012; 95% CI: 1.004–1.019), working in health facilities providing COVID-19 treatment (OR = 1.58, 95% CI: 1.04–2.39), having direct contact with patients or their bio-samples (physicians, nurses and laboratory workers; OR = 1.42, 95% CI: 1.02–1.99), low confidence in the available personal protective equipment (OR = 0.846; 95% CI: 0.744–0.962) and low knowledge on COVID-19 prevention and treatment (OR = 0.853; 95% CI: 0.739–0.986). In conclusion, many frontline HCWs experienced increased stress during the COVID-19 outbreak in Da Nang city. Reducing working time, providing essential personal protective equipment and enhancing the knowledge on COVID-19 will help to reduce this stress. Moreover, extra support is needed for HCWs who are directly exposed to COVID-19 patients.


Author(s):  
Stephanie Toigo ◽  
Michel Jacques ◽  
Tarek Razek ◽  
Ewa Rajda ◽  
Sidney Omelon ◽  
...  

ABSTRACT Objective: Bottlenecks in the personal protective equipment (PPE) supply chain have contributed to shortages of PPE during the COVID-19 pandemic, resulting in fractures in the functionality of healthcare systems. This study was conducted with the aim of determining the effectiveness of retrofitted commercial snorkel masks as an alternative respirator for healthcare workers during infectious disease outbreaks. Methods: A retrospective analysis was performed, analyzing qualitative and quantitative fit test results of the retrofitted Aria Ocean Reef® full-face snorkeling mask on healthcare workers at the McGill University Health Centre between April-June 2020. Historical fit test results, using medical-grade respirators, for healthcare workers were also analyzed. Results: During the study period, 71 participants volunteered for fit testing, 60.6% of which were nurses. The overall fit test passing rate using the snorkel mask was 83.1%. Of the participants who did not previously pass fit testing with medical-grade respirators, 80% achieved a passing fit test with the snorkel respirator. Conclusions: The results suggest that this novel respirator may be an effective and feasible alternative solution to address PPE shortages, while still providing healthcare workers with ample protection. Additional robust testing will be required to ensure that respirator fit is maintained, after numerous rounds of disinfection.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Duy Duong Nguyen ◽  
Patricia McCabe ◽  
Donna Thomas ◽  
Alison Purcell ◽  
Maree Doble ◽  
...  

AbstractFacemasks are essential for healthcare workers but characteristics of the voice whilst wearing this personal protective equipment are not well understood. In the present study, we compared acoustic voice measures in recordings of sixteen adults producing standardised vocal tasks with and without wearing either a surgical mask or a KN95 mask. Data were analysed for mean spectral levels at 0–1 kHz and 1–8 kHz regions, an energy ratio between 0–1 and 1–8 kHz (LH1000), harmonics-to-noise ratio (HNR), smoothed cepstral peak prominence (CPPS), and vocal intensity. In connected speech there was significant attenuation of mean spectral level at 1–8 kHz region and there was no significant change in this measure at 0–1 kHz. Mean spectral levels of vowel did not change significantly in mask-wearing conditions. LH1000 for connected speech significantly increased whilst wearing either a surgical mask or KN95 mask but no significant change in this measure was found for vowel. HNR was higher in the mask-wearing conditions than the no-mask condition. CPPS and vocal intensity did not change in mask-wearing conditions. These findings implied an attenuation effects of wearing these types of masks on the voice spectra with surgical mask showing less impact than the KN95.


Author(s):  
Meike M. Neuwirth ◽  
Frauke Mattner ◽  
Robin Otchwemah

AbstractAdherence observations of health care workers (HCW) revealed deficiencies in the use of recommended personal protective equipment (PPE) among HCW caring in COVID-19 and non-COVID-19 wards during the first period of the SARS-CoV-2 pandemic in a university hospital in Germany. The adherence to wearing surgical face or FFP2-masks and disinfecting hands prior to donning and after doffing the PPE was significantly higher in COVID-19 wards However, there was no total adherence of 100% in COVID-19 wards.


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