scholarly journals Real-world impact of vaccination on COVID-19 incidence in health care personnel at an academic medical center

2021 ◽  
pp. 1-21
Author(s):  
Sarah E. Waldman ◽  
Jason Y. Adams ◽  
Timothy E. Albertson ◽  
Maya M. Juárez ◽  
Sharon L Myers ◽  
...  
Keyword(s):  
Real World ◽  
Medical Center ◽  
Vaccination Campaign ◽  
Academic Medical Center ◽  
Vaccine Hesitancy ◽  
Healthcare Personnel ◽  
Frontline Employees ◽  
Work Location ◽  
Respiratory Therapists ◽  
Academic Medical

Abstract Objective: COVID-19 vaccination effectiveness in healthcare personnel (HCP) has been established, however, questions remain about its performance in high-risk healthcare occupations and work locations. We describe the effect of a COVID-19 HCP vaccination campaign on SARS-CoV-2 infection by timing of vaccination, job type, and work location. Methods: A retrospective review of COVID-19 vaccination acceptance, incidence of post-vaccination COVID-19 infection, hospitalization, and mortality among 16,156 faculty, students, and staff at a large academic medical center was conducted. Data were collected 8 weeks prior to the start of Phase 1a vaccination of frontline employees and ended 11 weeks after campaign completion. Results: COVID-19 employee incidence rate at our institution decreased from 3.2% during the 8 weeks prior to the start of vaccinations to 0.38% by four weeks after campaign initiation. SARS-CoV-2 infection risk was reduced among individuals receiving a single vaccination (HR = 0.52 [0.40, 0.68], p<0.0001) and further reduced with 2 doses of vaccine (HR = 0.17 [0.09, 0.32], p<0.0001). By two weeks after the second dose, the observed case positivity rate was 0.04%. Among Phase 1a HCP, we observed a lower risk of SARS-CoV-2 infection among physicians and a trend toward higher risk for respiratory therapists independent of vaccination status. Rates of infection were similar in a sub-group of nurses when examined by work location. Conclusions: Our findings show the real-world effectiveness of COVID-19 vaccination in HCP. Despite these encouraging results, unvaccinated HCP remain at an elevated risk of infection highlighting the need for targeted outreach to combat vaccine hesitancy.

scholarly journals Alcohol Hand Rub Significantly Reduces Overall Bacterial Bioburden on Stethoscopes in a Real-World Clinical Setting

2020 ◽  
Vol 41 (S1) ◽  
pp. s114-s115
Author(s):  
Alexandra Johnson ◽  
Bobby Warren ◽  
Deverick John Anderson ◽  
Melissa Johnson ◽  
Isabella Gamez ◽  
...  
Keyword(s):  
Real World ◽  
Medical Center ◽  
Academic Medical Center ◽  
Randomized Study ◽  
Healthcare Providers ◽  
Clinical Workflow ◽  
Provider Type ◽  
Academic Medical ◽  
Rn Students ◽  
The Impact

Background: Stethoscopes are a known vector for microbial transmission; however, common strategies used to clean stethoscopes pose certain barriers that prevent routine cleaning after every use. We aimed to determine whether using readily available alcohol-based hand rub (ABHR) would effectively reduce bacterial bioburden on stethoscopes in a real-world setting. Methods: We performed a randomized study on inpatient wards of an academic medical center to assess the impact of using ABHR (AlcareExtra; ethyl alcohol, 80%) on the bacterial bioburden of stethoscopes. Stethoscopes were obtained from healthcare providers after routine use during an inpatient examination and were randomized to control (no intervention) or ABHR disinfection (2 pumps applied to tubing and bell or diaphragm by study personnel, then allowed to dry). Cultures of the tubing and bell or diaphragm were obtained with premoistened cellulose sponges. Sponges were combined with 1% Tween20-PBS and mixed in the Seward Stomacher. The homogenate was centrifuged and all but ~5 mL of the supernatant was discarded. Samples were plated on sheep’s blood agar and selective media for clinically important pathogens (CIPs) including S. aureus, Enterococcus spp, and gram-negative bacteria (GNB). CFU count was determined by counting the number of colonies on each plate and using dilution calculations to calculate the CFU of the original ~5 mL homogenate. Results: In total, 80 stethoscopes (40 disinfection, 40 control) were sampled from 46 physicians (MDs) and MD students (57.5%), 13 advanced practice providers (16.3%), and 21 nurses (RNs) and RN students (26.3%). The median CFU count was ~30-fold lower in the disinfection arm compared to control (106 [IQR, 50–381] vs 3,320 [986–4,834]; P < .0001). The effect was consistent across provider type, frequency of recent usual stethoscope cleaning, age, and status of pet ownership (Fig. 1). Overall, 26 of 80 (33%) of stethoscopes harbored CIP. The presence of CIP was lower but not significantly different for stethoscopes that underwent disinfection versus controls: S. aureus (25% vs 32.5%), Enterococcus (2.5% vs 10%), and GNB (2.5% vs 5%). Conclusions: Stethoscopes may serve as vectors for clean hands to become recontaminated immediately prior to performing patient care activities. Using ABHR to clean stethoscopes after every use is a practical and effective strategy to reduce overall bacterial contamination that can be easily incorporated into clinical workflow. Larger studies are needed to determine the efficacy of ABHR at removing CIP from stethoscopes as stethoscopes in both arms were frequently contaminated with CIP. Prior cleaning of stethoscopes on the study day did not seem to impact contamination rates, suggesting the impact of alcohol foam disinfection is short-lived and may need to be repeated frequently (ie, after each use).Funding: NoneDisclosures: NoneDisclosures: NoneFunding: None

scholarly journals Healthcare personnel absenteeism, presenteeism, and staffing challenges during epidemics

2020 ◽  
pp. 1-4
Author(s):  
Douglas W. Challener ◽  
Laura E. Breeher ◽  
JoEllen Frain ◽  
Melanie D. Swift ◽  
Pritish K. Tosh ◽  
...  
Keyword(s):  
Seasonal Influenza ◽  
Medical Center ◽  
Academic Medical Center ◽  
The United States ◽  
Healthcare Personnel ◽  
Linear Regression Models ◽  
Influenza Like Illness ◽  
Healthcare Workforce ◽  
Academic Medical ◽  
Hourly Employees

Abstract: Objective: Presenteeism is an expensive and challenging problem in the healthcare industry. In anticipation of the staffing challenges expected with the COVID-19 pandemic, we examined a decade of payroll data for a healthcare workforce. We aimed to determine the effect of seasonal influenza-like illness (ILI) on absences to support COVID-19 staffing plans. Design: Retrospective cohort study. Setting: Large academic medical center in the United States. Participants: Employees of the academic medical center who were on payroll between the years of 2009 and 2019. Methods: Biweekly institutional payroll data was evaluated for unscheduled absences as a marker for acute illness-related work absences. Linear regression models, stratified by payroll status (salaried vs hourly employees) were developed for unscheduled absences as a function of local ILI. Results: Both hours worked and unscheduled absences were significantly related to the community prevalence of influenza-like illness in our cohort. These effects were stronger in hourly employees. Conclusions: Organizations should target their messaging at encouraging salaried staff to stay home when ill.

Implementation of an Enhanced Safety-Engineered Sharp Device Oversight and Bloodborne Pathogen Protection Program at a Large Academic Medical Center

2014 ◽  
Vol 35 (11) ◽  
pp. 1383-1390 ◽  
Author(s):  
Thomas R. Talbot ◽  
Deede Wang ◽  
Melanie Swift ◽  
Paul St. Jacques ◽  
Susan Johnson ◽  
...  
Keyword(s):  
Program Analysis ◽  
Medical Center ◽  
Academic Medical Center ◽  
Healthcare Personnel ◽  
Safety Device ◽  
Bloodborne Pathogens ◽  
Academic Medical ◽  
Online Submission ◽  
Vanderbilt University ◽  
Safe Practices

Objective.Exposure of healthcare personnel to bloodborne pathogens (BBPs) can be prevented in part by using safety-engineered sharp devices (SESDs) and other safe practices, such as double gloving. In some instances, however, safer devices and practices cannot be utilized because of procedural factors or the lack of a manufactured safety device for the specific clinical use. In these situations, a standardized system to examine requests for waiver from expected practices is necessaryDesign.Before-after program analysis.Setting.Large academic medical center.Interventions.Vanderbilt University Medical Center developed a formalized system for an improved waiver process, including an online submission and tracking site, and standards surrounding implementation of core safe practices. The program’s impact on sharp device injuries and utilization of double gloving and blunt sutures was examined.Results.Following implementation of the enhanced program, there was an increase in the amount of undergloves and blunt sutures purchased for surgical procedures, suggesting larger utilization of these practices. The rate of sharp device injuries of all at-risk employees decreased from 2.32% to 2.12%, but this decline was not statistically significant (P = .14). The proportion of reported injuries that were deemed preventable significantly decreased from 72.7% (386/531) before implementation to 63.9% (334/523; P = .002) after implementation of the enhanced program.Conclusions.An enhanced BBP protection program was successful at providing guidance to increase safe practices and at improving the management of SESD waiver requests and was associated with a reduction in preventable sharp device injuries.

scholarly journals 565. Risk of COVID-19 Among Healthcare Workers After Launch of Vaccination Campaign at an Academic Medical Center

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S384-S385
Author(s):  
Bhagyashri D Navalkele ◽  
Jose Lucar ◽  
James B Brock ◽  
Jason Parham
Keyword(s):  
Healthcare Workers ◽  
Medical Center ◽  
Severe Disease ◽  
Vaccination Campaign ◽  
Academic Medical Center ◽  
Complete Recovery ◽  
Healthcare Facility ◽  
Asymptomatic Infection ◽  
Academic Medical ◽  
The Impact

Abstract Background Coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 virus affected healthcare workers (HCWs) adding additional burden on staffing shortages. COVID-19 vaccination (mRNA 1273 and BNT162b2) has been shown to protect against severe disease, death and reduced risk of asymptomatic infection and transmission from fully vaccinated individuals. Here, we present the impact of COVID-19 vaccination (CoVac) on risk of developing COVID-19 based on test results among unvaccinated and vaccinated HCWs. Methods Our academic medical center with 11,785 HCWs on its Jackson campus initiated non-mandatory CoVac among HCWs with BNT162b2 on December 16, 2020. Individuals ≥ 2 weeks after 1st dose of vaccine were defined as partially vaccinated and those ≥2 weeks from 2nd dose of vaccine were defined as fully vaccinated. Per facility policy, all symptomatic HCWs (irrespective of vaccination status) were recommended to undergo SARS-CoV-2 RT-PCR testing. Asymptomatic HCWs were also tested upon household exposure, however, this policy was changed on March 9th 2021 to allow fully vaccinated asymptomatic HCWs to work without need for quarantine or testing. Universal masking policy among HCWs remained effective at our center during study period. Results Between the launch of COVID-19 vaccination on December 16, 2020 and April 30, 2021, 5,855 HCWs received one dose of vaccine, and 5,687 received both doses. A total of 1,329 unique HCWs underwent COVID-19 testing between January 4, 2021 and April 30, 2021. Of those, 217 (16.3%) tested positive for SARS-CoV-2 infection; 204 were unvaccinated, 7 were partially vaccinated, and 6 were fully vaccinated (figure 1). Of the 6 fully vaccinated employees, 1 was asymptomatic (testing for travel purposes), 4 had mild symptoms, and one elderly employee required hospitalization with oxygen supplementation and had a complete recovery. No facility outbreaks were reported related to asymptomatic, work exposed, fully vaccinated HCWs. Unvaccinated healthcare workers were more likely to test positive for SARS-CoV-2 compared to partially and fully vaccinated healthcare workers. Conclusion COVID-19 vaccination protected HCWs by reducing risk for developing COVID-19. Vaccinating healthcare workers is a crucial infection prevention measure to reduce disease burden, avoid staffing shortages and create a safe environment in the healthcare facility to prevent transmission to other staff and at-risk patients. Disclosures All Authors: No reported disclosures

Real-World Experience Using Cefpodoxime and Cefuroxime Axetil for Urinary Tract Infections at a Large Academic Medical Center

2020 ◽  
Vol 29 (1) ◽  
pp. e27-e31
Author(s):  
Hongkai Bao ◽  
Shin-Pung Jen ◽  
Xian Jie (Cindy) Chen ◽  
Justin Siegfried ◽  
Vinh P. Pham ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Real World ◽  
Medical Center ◽  
Academic Medical Center ◽  
Cefuroxime Axetil ◽  
Academic Medical ◽  
Tract Infections

Evaluation of Medication Administration Timing—Are We Meeting Our Goals?

2020 ◽  
pp. 089719002090545
Author(s):  
Craig Furnish ◽  
Samantha Wagner ◽  
Angela Dangler ◽  
Kerry Schwarz ◽  
Toby Trujillo ◽  
...  
Keyword(s):  
Medical Center ◽  
Academic Medical Center ◽  
Medication Administration ◽  
Respiratory Therapists ◽  
Policies And Procedures ◽  
Academic Medical ◽  
Hospital Policies ◽  
Inpatient Nursing ◽  
Administration Timing ◽  
Time Critical

Background: Per the Centers for Medicare and Medicaid Services (CMS) Code of Federal Regulations (CFR) 482.23(c) regarding medication administration, hospital policies and procedures must identify time-critical scheduled medications which must be administered within 30 minutes either before or after the scheduled dosing time, for a total administration window of 1 hour. Objective: The general objective of this analysis was to determine whether there was a difference in meeting medication administration goals when comparing time-critical to non-time-critical scheduled medication administration in both intensive care units (ICUs) and general medical floors at a large, academic medical center. Methods: Data were collected in 6 inpatient nursing units (3 general medical units and 3 ICUs) during the month of June 2017. Electronic medical record charge data for medications were used to evaluate timeliness of medication administration. Results: In total, 69,794 medication administrations were evaluated. Of 389 administrations of time-critical scheduled medications, 268 (69%) were administered on time. Of 69,405 administrations of non-time-critical scheduled medications, 58,099 (84%) were administered on time ( P < 0.001). ICUs had a higher percentage of on-time administrations than general medical units (89% vs 77%, P < 0.001), and nurses had a higher percentage of on-time administrations than respiratory therapists (84% vs 63%, P < 0.001). Conclusions: Non-time-critical scheduled medications were more commonly administered on time compared with time-critical scheduled medications. Staff education and optimizations to the electronic health record (EHR) are interventions that may improve administration of time-critical scheduled medications.

Real‐world use—Isavuconazole at a large academic medical center

Mycoses ◽  
2019 ◽  
Vol 62 (6) ◽  
pp. 534-541 ◽  
Author(s):  
Habiba Hassouna ◽  
Vasilios Athans ◽  
Kyle D. Brizendine
Keyword(s):  
Real World ◽  
Medical Center ◽  
Academic Medical Center ◽  
Academic Medical

scholarly journals The prevalence of COVID-19 in healthcare personnel in an adult and pediatric academic medical center

2021 ◽  
Vol 49 (5) ◽  
pp. 542-546
Author(s):  
John Shepard ◽  
Samantha M.R. Kling ◽  
Grace Lee ◽  
Frances Wong ◽  
John Frederick ◽  
...  
Keyword(s):  
Medical Center ◽  
Academic Medical Center ◽  
Healthcare Personnel ◽  
Academic Medical

scholarly journals How Standard Are Standard Precautions? Knowledge and Attitudes Toward Standard Precautions at an Academic Medical Center

2020 ◽  
Vol 41 (S1) ◽  
pp. s254-s254
Author(s):  
Rebecca Faller ◽  
Priya Sampathkumar ◽  
Stacy (Tram) Ung
Keyword(s):  
Hand Hygiene ◽  
Waste Disposal ◽  
Medical Center ◽  
Academic Medical Center ◽  
Significant Proportion ◽  
Healthcare Setting ◽  
Healthcare Personnel ◽  
Standard Precautions ◽  
Respiratory Therapists ◽  
Inpatient Settings

Background: Standard precautions are the basis of infection prevention and include a set of common-sense infection control practices that prevent transmission of diseases acquired by contact with blood, body fluids, nonintact skin, and mucous membranes. These measures include hand hygiene, personal protective equipment (PPE), cleaning and disinfecting, linen handling, waste disposal, sharps safety and respiratory etiquette. Standard precautions require that the risk for exposure be assessed and appropriate precautions taken based on risk. Observations and anecdotal evidence have led us to believe that understanding of standard precautions is lacking among healthcare personnel. Methods: A survey was conducted at a large health system to assess knowledge and practices related to specific elements of standard precautions. Results: More than 3,000 HCWs responded from inpatient settings (41%), outpatient settings (37%), and both settings (22%). Nurses comprised the majority of respondents (54%), and others included physicians (9%), respiratory therapists, as well as physical and occupational therapists. Discussion: The vast majority (96%) of respondents agreed that standard precautions were required in the care of all patients, but a significant proportion (34%) interpreted that to mean that standard precautions always involve wearing gloves, and 22.5% thought that PPE was always required for standard precautions. Hand hygiene and sharps safety were identified as the best understood elements of standard precautions. Respiratory etiquette and cleaning and disinfection were reported as the least understood elements, with PPE, waste disposal, and linen handling also being reported as inadequately understood components of standard precautions (Fig. 1). Conclusions: In an era of increasing drug resistance and fewer effective antibiotics, standard precautions are our best defense against the spread of infections in the healthcare setting. Our survey showed that there is room for improvement among healthcare workers in understanding of the elements of standard precautions. We plan to use the survey to craft a targeted education campaign to improve understanding of and adherence to standard precautions.Funding: NoneDisclosures: None

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