scholarly journals COVID-19 screening system utilizing daily symptom attestation helps identify hospital employees who should be tested to protect patients and co-workers

2021 ◽  
pp. 1-17
Author(s):  
Ellen Kim ◽  
Charles Morris ◽  
Michael Klompas ◽  
Haipeng Zhang ◽  
Adam Landman ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Data Linkage ◽  
Medical Center ◽  
Academic Medical Center ◽  
Health Records ◽  
Hospital Employees ◽  
Runny Nose ◽  
Symptom Screening ◽  
Academic Medical ◽  
Chi Squared

ABSTRACT Objective: To investigate the effectiveness of a daily attestation system used by employees of a multi-institutional academic medical center, which comprised of symptom-screening, self-referrals to the Occupational Health team, and/or a COVID-19 test. Design: Retrospective cohort study of all employee attestations and COVID-19 tests performed between March and June 2020. Setting: A large multi-institutional academic medical center, including both inpatient and ambulatory settings. Participants: All employees who worked at the study site. Methods: Data was combined from the attestation system (COVIDPass), the employee database, and the electronic health records, and was analyzed using descriptive statistics including chi-squared, Wilcoxon, and Kruskal-Wallis tests. We investigated whether an association existed between symptomatic attestations by the employees and them testing positive for COVID-19. Results: After data linkage and cleaning, there were 2,117,298 attestations submitted by 65,422 employees between March and June 2020. Most attestations were asymptomatic (99.9%). The most commonly reported symptoms were sore throat (910), runny nose (637), and cough (570). Of the 2,026 employees who ever attested symptomatic, 905 employees were tested within 14 days of a symptomatic attestation, and 114 (13%) of these tests were positive. The most common symptoms associated with a positive COVID-19 test were anosmia (23% vs 4%) and fever (46% vs 19%). Conclusions: Daily symptom attestations amongst healthcare workers identified a handful of employees with Covid-19. While the number of positives was low, attestations may help keep unwell employees off campus to try to prevent transmissions.

scholarly journals 421. Effect of SARs-Cov-2 mRNA Vaccination in Healthcare Workers with Household COVID Exposure

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S311-S311
Author(s):  
Laura Selby ◽  
Richard Starlin
Keyword(s):  
Healthcare Workers ◽  
Screening Program ◽  
Medical Center ◽  
Severe Disease ◽  
Academic Medical Center ◽  
Tertiary Care ◽  
Limited Data ◽  
Viral Shedding ◽  
Academic Medical ◽  
Significant Burden

Abstract Background Healthcare workers have experienced a significant burden of COVID-19 disease. COVID mRNA vaccines have shown great efficacy in prevention of severe disease and hospitalization due to COVID infection, but limited data is available about acquisition of infection and asymptomatic viral shedding. Methods Fully vaccinated healthcare workers at a tertiary-care academic medical center in Omaha Nebraska who reported a household exposure to COVID-19 infection are eligible for a screening program in which they are serially screened with PCR but allowed to work if negative on initial test and asymptomatic. Serial screening by NP swab was completed every 5-7 days, and workers became excluded from work if testing was positive or became symptomatic. Results Of the 94 employees who were fully vaccinated at the time of the household exposure to COVID-19 infection, 78 completed serial testing and were negative. Sixteen were positive on initial or subsequent screening. Vaccine failure rate of 17.0% (16/94). Healthcare workers exposed to household COVID positive contact Conclusion High risk household exposures to COVID-19 infection remains a significant potential source of infections in healthcare workers even after workers are fully vaccinated with COVID mRNA vaccines especially those with contact to positive domestic partners. Disclosures All Authors: No reported disclosures

scholarly journals In depth characterization of vaccine breakthrough infections with SARS-CoV-2 among healthcare workers of a Dutch academic medical center

2021 ◽  
Author(s):  
Lidewij W Rümke ◽  
Femke C Groenveld ◽  
Yvonne M G van Os ◽  
Patrique Praest ◽  
Anniek A N Tanja ◽  
...  
Keyword(s):  
Immune Responses ◽  
Healthcare Workers ◽  
Medical Center ◽  
Academic Medical Center ◽  
Risk Exposure ◽  
Live Virus ◽  
Viral Loads ◽  
Academic Medical ◽  
T Cell Immune Responses

Abstract SARS-CoV-2 infection after COVID-19 vaccination raises concerns about the emergence of vaccine escape variants. Here we characterize 14 breakthrough infections among 5860 fully vaccinated Dutch healthcare workers ≥14 days post final dose of vaccination with either BNT162b2, mRNA-1273 or Ad26.COV2.S. These breakthrough infections presented with regular B.1.1.7 (Alpha) and B.1.617.2 (Delta) variants and high viral loads, despite normal vaccine induced B- and T-cell immune responses detected by live virus neutralization assays and ELISpot. High-risk exposure settings, such as in households, indicate a potential risk of viral transmission despite full vaccination.

scholarly journals The Epidemiology of Methicillin-ResistantStaphylococcus aureuson a Burn Trauma Unit

2012 ◽  
Vol 33 (11) ◽  
pp. 1118-1125 ◽  
Author(s):  
Marin Schweizer ◽  
Melissa Ward ◽  
Sandra Cobb ◽  
Jennifer McDanel ◽  
Laurie Leder ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Medical Center ◽  
Academic Medical Center ◽  
Nasal Carriage ◽  
Burn Trauma ◽  
Trauma Unit ◽  
Time Period ◽  
Academic Medical ◽  
A Site ◽  
Mrsa Colonization

Objective.We assessed the frequency and relatedness of methicillin-resistantStaphylococcus aureus(MRSA) isolates to determine whether healthcare workers, the environment, or admitted patients could be a reservoir for MRSA on a burn trauma unit (BTU). We also assessed risk factors for MRSA colonization among BTU patients.Design.Prospective cohort study and surveillance for MRSA carriage.Setting.BTU of a Midwestern academic medical center.Patients and Participants.Patients admitted to a BTU from February 2009 through January 2010 and healthcare workers on this unit during the same time period.Methods.Samples for MRSA culture were collected on admission from the nares and wounds of all BTU patients. We also had collected culture samples from the throat, axilla, antecubital fossa, groin, and perianal area of 12 patients per month. Samples collected from healthcare workers' nares and from environmental sites were cultured quarterly. MRSA isolates were typed by pulsed-field gel electrophoresis.Results.Of 144 patients, 24 (17%) carried MRSA in their nares on admission. Male sex (odds ratio [OR], 5.51; 95% confidence interval [95% CI], 1.25–24.30), admission for necrotizing fasciitis (OR, 7.66; 95% CI, 1.64–35.81), and MRSA colonization of a site other than the nares (OR, 23.40; 95% CI, 6.93–79.01) were independent predictors of MRSA nasal carriage. Cultures of samples collected from 4 healthcare workers and 4 environmental cultures had positive results. Two patients were colonized with strains that were indistinguishable from strains collected from a healthcare worker or the environment.Conclusions.Patients were a major reservoir for MRSA. Infection control efforts should focus on preventing transmission of MRSA from patients who are MRSA carriers to other patients on the unit.

Reliability and Construct Validity of the Complexity Compression Questionnaire

2014 ◽  
Vol 22 (2) ◽  
pp. 291-301 ◽  
Author(s):  
Ronda G. Hughes ◽  
Linda Fridlington ◽  
Polly Ryan
Keyword(s):  
United States ◽  
Factor Analysis ◽  
Organizational Change ◽  
Construct Validity ◽  
Medical Center ◽  
Academic Medical Center ◽  
Time Frame ◽  
Factor Solution ◽  
Health Records ◽  
Academic Medical

Background and Purpose: The purpose of the study was to evaluate the reliability and construct validity of the Complexity Compression Questionnaire (CCQ), a 28-item instrument designed to explain nurses’ experiences when assuming multiple responsibilities in a compressed time frame. Methods: Data were obtained from 607 registered nurses in an academic medical center in the midwestern United States who participated in a larger study on system-wide organizational change involving upgrading electronic health records. Results: Cronbach’s alpha for the 26-item CCQ, was .91. Exploratory factor analysis supported a 5-factor solution that explained 53.6% of the variance. Conclusions: The CCQ may be a useful tool for measurement of the effects of organizational change on the complexity of the work of nurses.

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

The role of the radiation oncologist in goals-of-care discussions.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 42-42
Author(s):  
Lauren C. Das ◽  
Christina H. Son ◽  
Ellen Wasgatt Daily ◽  
Stacie K. Levine ◽  
Olwen Mary Hahn ◽  
...  
Keyword(s):  
Medical Center ◽  
Performance Status ◽  
Academic Medical Center ◽  
Formal Training ◽  
Similar Frequency ◽  
Goals Of Care ◽  
Electronic Survey ◽  
Response Formats ◽  
Academic Medical ◽  
Chi Squared

42 Background: Effective goals-of-care discussions (GOCD) are essential when counseling patients with incurable malignancies. Because radiation and medical oncologists (RO; MO) often collaborate, their respective roles in GOCD can be unclear. This study aims to explore how often MO and RO initiate GOCD, barriers to GOCD, and MO opinions of RO conducting GOCD. Methods: RO and MO at NCI-designated comprehensive cancer centers were invited to participate in an anonymous electronic survey. The survey collected demographics and opinions regarding GOCD, training in conducting GOCD, and 3 case scenarios. The participants were provided with the GOCD definition: “A goals-of care discussion defines a patient's expected prognosis, elicits his or her values and preferences, and considers these preferences in formulating a recommendation for treatment and/or supportive care.” Response formats were Yes/No, Likert, or free response. Statistical analysis was performed with chi-squared and Wilcoxon rank-sum tests. Likert scores are reported as median[interquartile range]. Results: 554 RO and 1604 MO were successfully sent survey invitations. 76 (13.7%) RO and 153 (9.5%) MO responded with complete surveys. There was no difference in the gender distribution of survey respondents for RO and MO (67% vs 59% male, p = 0.26). Practice setting was academic medical center for 93% of respondents. 91% of respondents reported seeing ≤ 10 new cancer patients a week. MO were more likely to see metastatic or incurable patients. 63% of RO and 66% of MO reported having GOCD with > 50% of their patients (p = .94). MO were more comfortable conducting GOC discussions compared with RO (5[4-5] vs 4[3-5], p < .01). When asked how important it was for RO to conduct GOCD, RO ratings were higher than MO (5[4-5] vs 4[3-5], p = .02). 18% of RO and 42% of MO received formal training conducting GOCD (p < .01). The most common factors for initiating a GOCD were declining performance status (74%) and poor estimated life expectancy (69%). Conclusions: Although MO and RO conduct GOCD in similar frequency, MO report being more comfortable conducting GOCD and are more likely to have formal training. Compared to MO, RO rate the importance of RO conducting GOCD higher.

scholarly journals Healthcare workers’ perspectives on coronavirus testing availability: a cross sectional survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elena Byhoff ◽  
Jessica K. Paulus ◽  
Rubeen Guardado ◽  
Julia Zubiago ◽  
Alysse G. Wurcel
Keyword(s):  
Healthcare Workers ◽  
Medical Center ◽  
Academic Medical Center ◽  
Full Time ◽  
Patient Support ◽  
Hospital Workers ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Hospital Employees ◽  
The Impact

Abstract Background Studies on the impact of the novel SARS-CoV-2 virus (COVID) for healthcare workers (HCWs) rarely include the full spectrum of hospital workers, including less visible patient support roles. In the early days of the pandemic, COVID testing was preferentially available to HCWs. The objective of this study was to understand how individual experiences for all HCWs during the pandemic were associated with perceptions of access to, and receipt of COVID testing . Methods All hospital employees (n = 6736) in a single academic medical center in Boston, Massachusetts were invited to participate in a cross-sectional survey regarding perceived access to, and receipt of COVID testing during the first wave of the pandemic (March – August 2020). Responses were linked to human resources data. Log binomial univariate and multivariable models were used to estimate associations between individual and employment variables and COVID testing. Results A total of 2543 employees responded to the survey (38 %). The mean age was 40 years (± 14). Respondents were female (76 %), white (55 %), worked as nurses (27 %), administrators (22 %) and patient support roles (22 %); 56 % of respondents wanted COVID testing. Age (RR 0.91, CI 0.88–0.93), full time status (RR 0.85, CI 0.79–0.92), employment tenure (RR 0.96, CI 0.94–0.98), changes in quality of life (RR 0.94, CI 0.91–0.96), changes in job duties (RR 1.19, CI 1.03–1.37), and worry about enough paid sick leave (RR 1.21, CI 1.12–1.30) were associated with interest in testing. Administrators (RR 0.64, CI 0.58–0.72) and patient support staff (RR 0.85, CI 0.78–0.92) were less likely than nurses to want testing. Age (RR 1.04, CI 1.01–1.07), material hardships (RR 0.87, CI 0.79–0.96), and employer sponsored insurance (RR 1.10, CI 1.00-1.22) were associated with receiving a COVID test. Among all employees, only administrative/facilities staff were less likely to receive COVID testing (RR 0.69, CI 0.59–0.79). Conclusions This study adds to our understanding of how hospital employees view availability of COVID testing. Hazard pay or other supports for hospital workers may increase COVID testing rates. These findings may be applicable to perceived barriers towards vaccination receipt.

scholarly journals A Qualitative Study of Physician Perspectives on Adaptation to Electronic Health Records

2019 ◽  
Author(s):  
Cynthia Judine Sieck ◽  
Nicole Pearl ◽  
Tiffani J. Bright ◽  
Po-Yin Yen
Keyword(s):  
Qualitative Study ◽  
Electronic Health Records ◽  
Medical Center ◽  
Academic Medical Center ◽  
Opportunity To Learn ◽  
Structured Interviews ◽  
Health Records ◽  
Physician Perspectives ◽  
Academic Medical ◽  
Electronic Health

Abstract Background Electronic Health Records (EHRs) have the potential to improve many aspects of care and their use has increased in the last decade. Because of this, acceptance and adoption of EHRs is less of a concern than adaptation to use. To understand this issue more deeply, we conducted a qualitative study of physician perspectives on EHR use to identify factors that facilitate adaptation.Methods We conducted semi-structured interviews with 9 physicians across a range of inpatient disciplines at a large Academic Medical Center. Interviews were conducted by phone, lasting approximately 30 minutes, and were transcribed verbatim for analysis. We utilized inductive and deductive methods in our analysis.Results We identified 4 major themes related to EHR adapation: impact of EHR changes on physicians, how physicians managed these changes, factors that facilitated adapation to using the EHR and adapting to using the EHR in the patient encounter. Within these themes, physicians felt that a positive mindset toward change, providing upgrade training that was tailored to their role, and the opportunity to learn from colleagues were important facilitators of adaption.Conclusions As EHR use moves beyond implementation, physicians continue to be required to adapt to the technology and to its frequent changes. Our study provides actionable findings that allow healthcare systems to focus on factors that facilitate the adaptation process for physicians.

Sign in / Sign up

Export Citation Format

Share Document