scholarly journals Outbreak of SARS-CoV-2 in hospitalized hemodialysis patients: an epidemiologic and genomic investigation

2021 ◽  
pp. 1-14
Author(s):  
Charles E. Marvil ◽  
Ahmed Babiker ◽  
Aaron Preston ◽  
Andrew Webster ◽  
Jeannette Guarner ◽  
...  
Keyword(s):  
Genome Sequencing ◽  
Healthcare Workers ◽  
Infection Prevention ◽  
Hemodialysis Patients ◽  
Hospitalized Patients ◽  
Epidemiological Investigation ◽  
Hemodialysis Session ◽  
Respiratory Hygiene

Abstract We performed an epidemiological investigation and SARS-CoV-2 genome sequencing to define the source and scope of an outbreak in a cluster of hospitalized patients. Lack of appropriate respiratory hygiene led to SARS-CoV-2 transmission to patients and healthcare workers during a single hemodialysis session, highlighting the importance of infection prevention precautions.

Barriers to infection prevention and control practice among Amhara region teaching hospitals in Ethiopia: Qualitative study

2019 ◽  
Vol 15 (2) ◽  
Author(s):  
Walelegn Worku Yallew ◽  
Abera Kumie ◽  
Feleke Moges Yehuala
Keyword(s):  
Healthcare Worker ◽  
Prevention And Control ◽  
Healthcare Workers ◽  
Infection Prevention ◽  
Teaching Hospitals ◽  
Infection Prevention And Control ◽  
Amhara Region ◽  
Implementation Barriers ◽  
Control Practice ◽  
And Control

Healthcare workers have good perception towards infection prevention, but there has been a poor practice towards it. Therefore, the aim of this study was to explore barriers to practice of infection prevention and control practice in teaching hospitals in Amhara region. A phenomenological approach used to explore the lived experience of healthcare workers and management staffs towards infection prevention practice and control. The data was collected from ten in-depth interviews and 23 focus group discussion participants, by face to face interview using open ended interview performed in safe and quiet places. Data was managed using OpenCode software version 4.03 and contents were analyzed thematically. Totally ten different barriers were identified, such as availability of facilities, shortage of material supply, lack of maintenance of facilities and equipment, high patient flow, experience, emergency situation, healthcare worker behaviour and healthcare worker’s information about infection prevention, low awareness of patients and visitors and overflow of families and visitors to the hospital. For effective infection prevention practice implementation, barriers should be considered via identifying specific organizational, healthcare worker, patients and visitors as targets.

scholarly journals Comparison of saliva with healthcare workers- and patient-collected swabs in the diagnosis of COVID-19 in a large cohort

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mitnala Sasikala ◽  
Yelamanchili Sadhana ◽  
Ketavarapu Vijayasarathy ◽  
Anand Gupta ◽  
Sarala Kumari Daram ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Early Stage ◽  
Cost Effective ◽  
Hospitalized Patients ◽  
Detection Sensitivity ◽  
Nasopharyngeal Swab ◽  
Predictive Values ◽  
Qrt Pcr ◽  
Asymptomatic Patients ◽  
Sensitivity Specificity

Abstract Background A considerable amount of evidence demonstrates the potential of saliva in the diagnosis of COVID-19. Our aim was to determine the sensitivity of saliva versus swabs collected by healthcare workers (HCWs) and patients themselves to assess whether saliva detection can be offered as a cost-effective, risk-free method of SARS-CoV-2 detection. Methods This study was conducted in a hospital involving outpatients and hospitalized patients. A total of 3018 outpatients were tested. Of these, 200 qRT-PCR-confirmed SARS-CoV-2-positive patients were recruited for further study. In addition, 101 SARS-CoV-2-positive hospitalized patients with symptoms were also enrolled in the study. From outpatients, HCWs collected nasopharyngeal swabs (NPS), saliva were obtained. From inpatients, HCWs collected swabs, patient-collected swabs, and saliva were obtained. qRT-PCR was performed to detect SARS-CoV-2 by TAQPATH assay to determine the sensitivity of saliva detection. Sensitivity, specificity and positive/negative predictive values (PPV, NPV) of detecting SARS-CoV-2 were calculated using MedCalc. Results Of 3018 outpatients (asymptomatic: 2683, symptomatic: 335) tested by qRT-PCR, 200 were positive (males: 140, females: 60; aged 37.9 ± 12.8 years; (81 asymptomatic, 119 symptomatic). Of these, saliva was positive in 128 (64%); 39 of 81 asymptomatic (47%),89 of 119 symptomatic patients (74.8%). Sensitivity of detection was 60.9% (55.4–66.3%, CI 95%), with a negative predictive value of 36%(32.9–39.2%, CI 95%).Among 101 hospitalized patients (males:65, females: 36; aged 53.48 ± 15.6 years), with HCW collected NPS as comparator, sensitivity of saliva was 56.1% (47.5–64.5, CI 95%), specificity 63.5%(50.4–75.3, CI95%) with PPV of 77.2% and NPV of 39.6% and that of self-swab was 52.3%(44–60.5%, CI95%), specificity 56.6% (42.3–70.2%, CI95%) with PPV 77.2% and NPV29.7%. Comparison of positivity with the onset of symptoms revealed highest detection in saliva on day 3 after onset of symptoms. Additionally, only saliva was positive in 13 (12.8%) hospitalized patients. Conclusion Saliva which is easier to collect than nasopharyngeal swab is a viable alternate to detect SARS-COV-2 in symptomatic patients in the early stage of onset of symptoms. Although saliva is currently not recommended for screening asymptomatic patients, optimization of collection and uniform timing of sampling might improve the sensitivity enabling its use as a screening tool at community level.

scholarly journals Improving knowledge, attitudes and practice to prevent COVID-19 transmission in healthcare workers and the public in Thailand

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rapeephan R. Maude ◽  
Monnaphat Jongdeepaisal ◽  
Sumawadee Skuntaniyom ◽  
Thanomvong Muntajit ◽  
Stuart D. Blacksell ◽  
...  
Keyword(s):  
General Public ◽  
Prevention And Control ◽  
Healthcare Workers ◽  
Infection Prevention ◽  
Control Measures ◽  
Infection Prevention And Control ◽  
The Public ◽  
Educational Videos ◽  
Prevention And Control Measures ◽  
And Control

Abstract Background Key infection prevention and control measures to limit transmission of COVID-19 include social distancing, hand hygiene, use of facemasks and personal protective equipment. However, these have limited or no impact if not applied correctly through lack of knowledge, inappropriate attitude or incorrect practice. In order to maximise the impact of infection prevention and control measures on COVID-19 spread, we undertook a study to assess and improve knowledge, attitudes and practice among 119 healthcare workers and 100 general public in Thailand. The study setting was two inpatient hospitals providing COVID-19 testing and treatment. Detailed information on knowledge, attitudes and practice among the general public and healthcare workers regarding COVID-19 transmission and its prevention were obtained from a combination of questionnaires and observations. Results Knowledge of the main transmission routes, commonest symptoms and recommended prevention methods was mostly very high (> 80%) in both groups. There was lower awareness of aerosols, food and drink and pets as sources of transmission; of the correct duration for handwashing; recommended distance for social/physical distancing; and about recommended types of face coverings. Information sources most used and most trusted were the workplace, work colleagues, health workers and television. The results were used to produce a set of targeted educational videos which addressed many of these gaps with subsequent improvements on retesting in a number of areas. This included improvements in handwashing practice with an increase in the number of areas correctly washed in 65.5% of the public, and 57.9% of healthcare workers. The videos were then further optimized with feedback from participants followed by another round of retesting. Conclusions Detailed information on gaps in knowledge, attitudes and practice among the general public and healthcare workers regarding COVID-19 transmission and its prevention were obtained from a combination of questionnaires and observations. This was used to produce targeted educational videos which addressed these gaps with subsequent improvements on retesting. The resulting videos were then disseminated as a resource to aid in efforts to fight COVID-19 in Thailand and worldwide.

scholarly journals Clinical Features of Maintenance Hemodialysis Patients with 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China

2020 ◽  
Vol 15 (8) ◽  
pp. 1139-1145 ◽  
Author(s):  
Jun Wu ◽  
Jushuang Li ◽  
Geli Zhu ◽  
Yanxia Zhang ◽  
Zhimin Bi ◽  
...  
Keyword(s):  
Clinical Features ◽  
Troponin I ◽  
Clinical Laboratory ◽  
Cardiac Injury ◽  
Hemodialysis Patients ◽  
Hospitalized Patients ◽  
Maintenance Hemodialysis ◽  
Computed Tomographic ◽  
Risk Of Death ◽  
Novel Coronavirus

Background and objectivesPrevious reports on the outbreak of coronavirus disease 2019 were on the basis of data from the general population. Our study aimed to investigate the clinical features of patients on maintenance hemodialysis.Design, setting, participants, & measurements In this retrospective, single-center study, we included 49 hospitalized patients on maintenance hemodialysis and 52 hospitalized patients without kidney failure (controls) with confirmed coronavirus disease 2019 at Tongren Hospital of Wuhan University from January 30, 2020 to March 10, 2020. Demographic, clinical, laboratory, and radiologic characteristics and treatment and outcomes data were analyzed. The final date of follow-up was March 19, 2020.ResultsThe median age of 101 patients was 62 years (interquartile range, 49–72). All patients were local residents of Wuhan. In terms of common symptoms, there were differences between patients on hemodialysis and controls (fatigue [59% versus 83%], dry cough [49% versus 71%], and fever [47% versus 90%]). Lymphocyte counts were decreased (0.8×109/L [patients on hemodialysis] versus 0.9×109/L [controls], P=0.02). Comparing patients on hemodialysis with controls, creatine kinase–muscle and brain type, myoglobin, hypersensitive troponin I, B-type natriuretic peptide, and procalcitonin were increased, and the percentage of abnormalities in bilateral lung was higher in computed tomographic scan (82% versus 69%, P=0.15) and unilateral lung was lower (10% versus 27%, P=0.03). Common complications including shock, acute respiratory distress syndrome, arrhythmia, and acute cardiac injury in patients on hemodialysis were significantly higher. Compared with controls, more patients on hemodialysis received noninvasive ventilation (25% versus 6%, P=0.008). As of March 19, 2020, three patients on hemodialysis (6%) were transferred to the intensive care unit and received invasive ventilation. Seven patients on hemodialysis (14%) had died.ConclusionsThe main symptoms of coronavirus disease 2019 pneumonia, including fever and cough, were less common in patients on hemodialysis. Patients on hemodialysis with coronavirus disease 2019 were at higher risk of death.

scholarly journals Evaluation of Assays for Measurement of Serum (Anti)oxidants in Hemodialysis Patients

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Tatjana Ruskovska ◽  
Eugene H. J. M. Jansen ◽  
Risto Antarorov
Keyword(s):  
Oxidative Stress ◽  
Statistical Significance ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
Total Serum ◽  
Antioxidant Assays ◽  
Hemodialysis Session ◽  
Anti Oxidant ◽  
Oxidant Status ◽  
Healthy Persons

Background. Various biomarkers and assays have been used for assessment of (anti)oxidant status in hemodialysis patients, including those intended for measurement of serum total (anti)oxidants, most often as a part of panel biomarkers.Methods. Serum (anti)oxidant status was measured in 32 chronically hemodialyzed patients and in 47 healthy persons, using two oxidations and three antioxidant assays.Results. The patients before the hemodialysis session have had higher values of total oxidants in comparison to the healthy persons, with a further increase during the hemodialysis. These findings were confirmed with both oxidation assays, but they differ in the percentage of increase and the statistical significance. All three antioxidant assays showed significantly higher values of the total serum antioxidants in the patients before the hemodialysis session in comparison to the healthy persons, and their significant decrease during the hemodialysis. However, the assays differ in the percentage of decrease, its statistical significance, and the correlations with uric acid.Conclusion. The variability of results of total (anti)oxidants which are obtained using different assays should be taken into account when interpreting data from clinical studies of oxidative stress, especially in complex pathologies such as chronic hemodialysis.

scholarly journals Process Mapping to Examine How Goals of Care Discussions and Decisions about Life-Sustaining Treatments Occur On Medical Wards: A Multi-Center Observational Study

2020 ◽  
Vol 15 (1) ◽  
pp. 12-25
Author(s):  
Dev Jayaraman ◽  
Nishan Sharma ◽  
Alannah Smrke ◽  
Jessica Simon ◽  
Peter Dodek ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Nous Avons ◽  
Healthcare Workers ◽  
Hospital Setting ◽  
Hospitalized Patients ◽  
Communication Process ◽  
Prise De Décision ◽  
Goals Of Care ◽  
Travailleurs De La Santé

BackgroundPoor quality communication about goals of care with seriously ill, hospitalized patients is associated with substantial discordance between prescribed medical orders for life-sustaining treatment and patients’ stated preferences. Designing tailored solutions to this discordance requires a better understanding of this communication process. ObjectiveTo acquire a detailed understanding of the process of communication about goals of care and decision making about life-sustaining treatments for hospitalized patients, and to seek opportunities for improvement. SettingMedical wards of three university-affiliated teaching hospitals in Canada. MethodAt each site, we used drop-in sessions and one-on-one interviews to consult with health care workers on eligible wards to create cross-functional (swim lane) maps of the process of communication about goals of care and decision making about life-sustaining treatments. Healthcare workers were also asked about barriers to this process to enable the identification of opportunities for improvement. ResultsA total of 112 healthcare workers provided input into the creation of process maps across the three sites. Common elements across sites were that: (1) physicians play a central role, (2) the full process for a given patient involves several interactions amongst members of the inter-professional team, and (3) the process is iterative. We also noted between-site variations in the location of GoC discussions and the extent to which trainees and multi-disciplinary team members were involved. Finally, we identified several key barriers that may serve as targets for future quality improvement efforts: suboptimal location of conversations, insufficient support of physician learners in goals-of-care conversations, and incomplete engagement of the inter-professional team. ConclusionEfforts to improve the quality of goals-of-care discussions and decision making about life-sustaining treatments in the hospital setting need to account for the central role played by physicians in the process but can be enhanced if they can more fully engage the inter-professional health care team.Resume Contexte Une communication de mauvaise qualité sur les objectifs des soins aux patients gravementmalades et hospitalisés est associée à une discordance importante entre les ordonnances médicales prescrites pour un traitement de survie et les préférences déclarées des patients. La conception de solutions adaptées à cette discordance nécessite une meilleure compréhension de ce processus de communication. ObjectifAcquérir une compréhension détaillée du processus de communication sur les objectifs des soins et la prise de décision sur les traitements de maintien de la vie pour les patients hospitalisés, et rechercher des possibilités d’amélioration. ParamètresLes services médicaux de trois hôpitaux universitaires canadiens affiliés à l’université. MéthodeSur chaque site, nous avons eu recours à des séances d’information et à des entretiens individuels pour consulter les travailleurs de la santé dans les services éligibles afin de créer des cartes interfonctionnelles (couloir de nage) du processus de communication sur les objectifs des soins et la prise de décision sur les traitements de maintien des fonctions vitales. Les travailleurs de la santé ont également été interrogés sur les obstacles à ce processus afin de permettre l’identification des possibilités d’amélioration. RésultatsAu total, 112 travailleurs de la santé ont participé à la création de cartes de processus sur les trois sites. Les éléments communs à tous les sites étaient les suivants : (1) les médecins jouent un rôle central, (2) le processus complet pour un patient donné implique plusieurs interactions entre les membres de l’équipe interprofessionnelle, et (3) le processus est itératif. Nous avons également noté des variations entre les sites en ce qui concerne le lieu des discussions du gouvernement et le degré d’implication des stagiaires et des membres de l’équipe pluridisciplinaire. Enfin, nous avons identifié plusieurs obstacles clés qui pourraient servir de cibles aux futurs efforts d’amélioration de la qualité : le lieu sous-optimal des conversations, le soutien insuffisant des apprenants médecins dans les conversations sur les objectifs de soins et l’engagement incomplet de l’équipe interprofessionnelle. ConclusionLes efforts visant à améliorer la qualité des discussions sur les objectifs des soins et la prise de décision concernant les traitements vitaux en milieu hospitalier doivent tenir compte du rôle central joué par les médecins dans le processus, mais peuvent être renforcés s’ils peuvent faire participer davantage l’équipe interprofessionnelle de soins de santé.

scholarly journals Seroprevalence of Antibodies against SARS-CoV-2 Infection among Healthcare Workers at a Tertiary Hospital in Saudi Arabia

2021 ◽  
Author(s):  
Hayat Mushcab ◽  
Jaffar Al-Tawfiq ◽  
Mohammed Ghamdi ◽  
Amani Babgi ◽  
Abdulrazack Amir ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Healthcare Workers ◽  
Infection Prevention ◽  
Seroconversion Rate ◽  
Tertiary Hospital ◽  
World Health ◽  
Infection Prevention And Control ◽  
Healthcare Organizations ◽  
And Control ◽  
Assessment Questionnaire

Abstract Background The nature of the healthcare workers' jobs standing at the frontline against the coronavirus disease 2019 (COVID-19) puts them at a higher risk of unknowingly contracting the disease and potentially contributing to the spread. This study aims to assess the overall positive seroconversion prevalence of SARS-CoV-2. Methods This is a longitudinal cohort study of healthcare workers at a tertiary hospital serving patients in several districts in the Eastern Province of Saudi Arabia. Participants were recruited between June - December 2020. Each participant had a serology blood test and completed the World Health Organization's risk factors assessment questionnaire. Results This study included 682 participants working in any capacity at a tertiary hospital, representing 15.7% of our population. Only 87 participants tested positive for SARS-CoV-2 antibodies, a prevalence of 12.7% of all participants. Of the 87 participants, 17 participants never tested positive for COVID-19 rt-PCR before the study, a prevalence of 2.9%. Moreover, the improper technique of using alcohol-based hand rub or soap and water after the risk of body fluid exposure and wearing personal protective equipment when indicated were found to be statistically significant to having positive SARS-CoV-2 IgG assay with P=0.02, P=0.03, and CI: 95% respectively. Conclusion Positive seroconversion rate was considerably low during the first wave of COVID-19 amongst our healthcare workers and similar to other healthcare organizations in Saudi Arabia. Seropositivity correlated significantly with adherence to infection prevention and control recommendations.

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