The case for wearable proximity devices to inform physical distancing among healthcare workers

Abstract Objective Despite the importance of physical distancing in reducing SARS-CoV-2 transmission, this practice is challenging in healthcare. We piloted use of wearable proximity beacons among healthcare workers (HCWs) in an inpatient unit to highlight considerations for future use of trackable technologies in healthcare settings. Materials and Methods We performed a feasibility pilot study in a non-COVID adult medical unit from September 28 to October 28, 2020. HCWs wore wearable proximity beacons, and interactions defined as <6 feet for ≥5 s were recorded. Validation was performed using direct observations. Results A total of 6172 close proximity interactions were recorded, and with the removal of 2033 false-positive interactions, 4139 remained. The highest proportion of interactions occurred between 7:00 Am–9:00 Am. Direct observations of HCWs substantiated these findings. Discussion This pilot study showed that wearable beacons can be used to monitor and quantify HCW interactions in inpatient settings. Conclusion Technology can be used to track HCW physical distancing.

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Healthcare Workers and Manual Patient Handling: A Pilot Study for Interdisciplinary Training

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17144971 ◽

2020 ◽

Vol 17 (14) ◽

pp. 4971

Author(s):

Elpidio Maria Garzillo ◽

Maria Grazia Lourdes Monaco ◽

Anna Rita Corvino ◽

Francesco D’Ancicco ◽

Daniela Feola ◽

...

Keyword(s):

Pilot Study ◽

Training Program ◽

Healthcare Workers ◽

Training Session ◽

Training Model ◽

Role Playing ◽

Patient Handling ◽

Healthcare Settings ◽

Effectiveness Of Training ◽

Specific Working

Manual patient handling (MPH) is a major occupational risk in healthcare settings. The aim of this study was to propose an MPH training model involving interdisciplinary aspects. A scheduled training program was performed with 60 healthcare workers (HCWs) from a hospital in Naples, Italy, providing training divided into three sections (occupational health—section one; physical therapy—section two; psychosocial section—section three) and lasting six hours. Fifty-two HCWs performed the training session. In section one, a questionnaire about risk perception related to specific working tasks was administered. Section two provided specific exercises for the postural discharge of the anatomical areas most involved in MPH. The last section provided teamwork consolidation through a role-playing exercise. The training program could also be useful for risk assessment itself, as they can examine the perceptions of the specific risk of the various workers and incorrect attitudes and therefore correct any incorrect procedures, reducing exposure to specific risks in the field. This pilot study proposes a training model that explores all aspects related to MPH risk exposure and also underlines the need for standardization of this formative model, which could represent a useful tool for studying the real effectiveness of training in workplaces.

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Usefulness of rapid antigen testing for SARS-CoV-2 screening of healthcare workers: a pilot study

Clinical and Experimental Medicine ◽

10.1007/s10238-021-00722-y ◽

2021 ◽

Author(s):

Anja Šterbenc ◽

Viktorija Tomič ◽

Urška Bidovec Stojković ◽

Katja Vrankar ◽

Aleš Rozman ◽

...

Keyword(s):

Pilot Study ◽

Healthcare Workers ◽

Antigen Testing

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Barriers to Physical Distancing among Healthcare Workers on an Academic Hospital Unit During the COVID-19 Pandemic

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2021.154 ◽

2021 ◽

pp. 1-26

Author(s):

Sara C. Keller ◽

Sara Pau ◽

Alejandra B. Salinas ◽

Opeyemi Oladapo-Shittu ◽

Sara E. Cosgrove ◽

...

Keyword(s):

Qualitative Study ◽

Healthcare Workers ◽

Tertiary Hospital ◽

Peer Leaders ◽

Human Factors Engineering ◽

Structured Interviews ◽

Hospital Unit ◽

Positive Behaviors ◽

Cognitive Aids ◽

Close Proximity

Abstract Background: Physical distancing among healthcare workers (HCW) is an essential strategy in preventing HCW-to-HCW transmission of the SARS-CoV-2 virus. Objective: To understand barriers to physical distancing among HCW on an inpatient unit and identify strategies for improvement. Design: Qualitative study including observations and semi-structured interviews over three months. Setting: A non-COVID adult general medical unit in an academic tertiary hospital. Participants: HCWs based on the unit. Methods: We performed a qualitative study in which we (1) observed HCWs activities and proximity to each other on the unit during weekday shifts July-October 2020 and (2) conducted semi-structured interviews of HCWs to understand their experiences with and perspectives of physical distancing in the hospital. Qualitative data were coded based on a human factors engineering model. Results: We completed 25 hours of observations and 20 HCW interviews. High-risk interactions often occurred during handoffs of care at shift changes and patient rounds, where HCWs gathered regularly in close proximity for at least 15 minutes. Identified barriers included spacing and availability of computers, the need to communicate confidential patient information, and the desire to maintain relationships at work. Conclusions: Physical distancing can be improved in hospitals by restructuring computer workstations, work rooms, and breakrooms; applying visible cognitive aids; adapting shift times; and supporting rounds and meetings with virtual conferencing. Additional strategies to promote staff adherence to physical distancing include rewarding positive behaviors, having peer leaders model physical distancing, and encouraging additional safe avenues for social connection at a safe distance.

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A critical and Integrated View of the Yeast Interactome

Comparative and Functional Genomics ◽

10.1002/cfg.412 ◽

2004 ◽

Vol 5 (5) ◽

pp. 382-402 ◽

Cited By ~ 12

Author(s):

Michael Cornell ◽

Norman W. Paton ◽

Stephen G. Oliver

Keyword(s):

High Throughput ◽

Protein Interactions ◽

False Positive ◽

Affinity Purification ◽

Information Management System ◽

Positive Interactions ◽

Global Studies ◽

Protein Protein Interactions ◽

Integrative Analyses ◽

Genome Information

Global studies of protein–protein interactions are crucial to both elucidating gene function and producing an integrated view of the workings of living cells. High-throughput studies of the yeast interactome have been performed using both genetic and biochemical screens. Despite their size, the overlap between these experimental datasets is very limited. This could be due to each approach sampling only a small fraction of the total interactome. Alternatively, a large proportion of the data from these screens may represent false-positive interactions. We have used the Genome Information Management System (GIMS) to integrate interactome datasets with transcriptome and protein annotation data and have found significant evidence that the proportion of false-positive results is high. Not all high-throughput datasets are similarly contaminated, and the tandem affinity purification (TAP) approach appears to yield a high proportion of reliable interactions for which corroborating evidence is available. From our integrative analyses, we have generated a set of verified interactome data for yeast.

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Acceptability of and symptom findings from an online symptom check-in tool for COVID-19 outpatient follow-up among a predominantly healthcare worker population

BMJ Open ◽

10.1136/bmjopen-2021-050444 ◽

2021 ◽

Vol 11 (9) ◽

pp. e050444

Author(s):

Colm Kerr ◽

Simon O’ Regan ◽

Donnacha Creagh ◽

Gerry Hughes ◽

Una Geary ◽

...

Keyword(s):

Healthcare Worker ◽

Healthcare Workers ◽

Primary Objective ◽

Text Messages ◽

Online Tool ◽

Mild Disease ◽

Healthcare Experiences ◽

Inpatient Settings ◽

Cardinal Symptoms

IntroductionHealth systems worldwide have had to prepare for a surge in volume in both the outpatient and inpatient settings since the emergence of COVID-19. Early international healthcare experiences showed approximately 80% of patients with COVID-19 had mild disease and therfore could be managed as outpatients. However, SARS-CoV-2 can cause a biphasic illness with those affected experiencing a clinical deterioration usually seen after day 4 of illness.ObjectiveWe created an online tool with the primary objective of allowing for virtual disease triage among the increasing number of outpatients diagnosed with COVID-19 at our hospital. Secondary aims included COVID-19 education and the promotion of official COVID-19 information among these outpatients, and analysis of reported symptomatology.MethodsOutpatients with acute COVID-19 disease received text messages from the hospital containing a link to an online symptom check-in tool which they were invited to complete.Results296 unique participants (72%) from 413 contacted by text completed the online check-in tool at least once, generating 831 responses from 1324 texts sent. 83% of text recipients and 91% of unique participants were healthcare workers. 7% of responses to the tool were from participants who admitted to a slight worsening of their symptoms during follow-up. Fatigue was the most commonly reported symptom overall (79%), followed by headache (72%). Fatigue, headache and myalgia were the most frequently reported symptoms in the first 3 days of illness. 8% of responses generated in the first 7 days of illness did not report any of the cardinal symptoms (fever, cough, dyspnoea, taste/smell disturbance) of COVID-19. Participants found the tool to be useful and easy to use, describing it as ‘helpful’ and ‘reassuring’ in a follow-up feedback survey (n=140). 93% said they would use such a tool in the future. 39% reported ongoing fatigue, 16% reported ongoing smell disturbance and 14% reported ongoing dyspnoea after 6 months.ConclusionThe online symptom check-in tool was found to be acceptable to participants and saw high levels of engagement and satisfaction. Symptomatology findings highlight the variety and persistence of symptoms experienced by those with confirmed COVID-19 disease

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Prevalence of active tuberculosis disease among healthcare workers and support staff in healthcare settings of the Amhara region, Ethiopia

PLoS ONE ◽

10.1371/journal.pone.0253177 ◽

2021 ◽

Vol 16 (6) ◽

pp. e0253177

Author(s):

Melashu Balew Shiferaw ◽

Mulusew Alemneh Sinishaw ◽

Desalegne Amare ◽

Genetu Alem ◽

Dawit Asefa ◽

...

Keyword(s):

Prevention And Control ◽

Healthcare Workers ◽

Support Staff ◽

Control Measures ◽

Health Centers ◽

Amhara Region ◽

Healthcare Settings ◽

Prevention And Control Measures ◽

Study Participants ◽

And Control

Background Health care workers (HCWs) are at an increased risk of acquiring tuberculosis (TB) compared to the general population, because of the frequent face to face contact or potential exposure to TB through shared air or space with infectious patient(s), regardless of economic setting and local TB incidence. Information on the burden of active TB disease among HCWs will help guide control measures, can be utilized to evaluate the effectiveness of TB infection prevention programs in the health care setting, and guide necessary actions. However, data on TB among HCW in Ethiopia is limited. Therefore, this study aimed to determine the prevalence of active TB disease among healthcare workers and support staff in healthcare settings in the Amhara region of Ethiopia. Methods A cross-sectional study design was used to recruit a total of 580 randomly selected study participants in the Amhara region. Data were collected over four months in selected hospitals and health centers. Implementation of TB prevention and control measures was evaluated using a standardized checklist. The main outcome indicator was active TB as measured by a laboratory diagnosis using GeneXpert technology. Results A total of 580 study participants were enrolled. The mean age was 31.3 (±7.8 standard deviation) years, with about two-thirds (65.3%) aged between 18–24 years. A total of 9 (1.6%) MTB cases were detected, 4 (1.4%) in HCWs and 5 (1.7%) in support staff, which did not significantly differ (P = 0.50). About 90% of the participants had not received TB infection prevention and control training ever. More than half (54%) of the study participants worked in poorly ventilated rooms. Triage of coughing patients was not practiced in 32% of the studied facilities (health centers and hospitals). Conclusions The magnitude of TB among healthcare workers and support staff in healthcare settings was higher than in the general population (140 per 100000 population). The status of implementation of tuberculosis prevention and control measures indicated missed opportunities. Hence, strict implementation of developed infection control plans of TB in healthcare settings needs to be improved.

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Physiological and Emotional Responses of Disabled Children to Therapeutic Clowns: A Pilot Study

Evidence-based Complementary and Alternative Medicine ◽

10.1093/ecam/neq008 ◽

2011 ◽

Vol 2011 ◽

pp. 1-10 ◽

Cited By ~ 21

Author(s):

Shauna Kingsnorth ◽

Stefanie Blain ◽

Patricia McKeever

Keyword(s):

Pilot Study ◽

Facial Expressions ◽

Positive Impact ◽

Well Being ◽

Physiological Arousal ◽

Single Subject ◽

Disabled Children ◽

Healthcare Settings ◽

Television Exposure ◽

And Behavior

This pilot study examined the effects of Therapeutic Clowning on inpatients in a pediatric rehabilitation hospital. Ten disabled children with varied physical and verbal expressive abilities participated in all or portions of the data collection protocol. Employing a mixed-method, single-subject ABAB study design, measures of physiological arousal, emotion and behavior were obtained from eight children under two conditions—television exposure and therapeutic clown interventions. Four peripheral autonomic nervous system (ANS) signals were recorded as measures of physiological arousal; these signals were analyzed with respect to measures of emotion (verbal self reports of mood) and behavior (facial expressions and vocalizations). Semistructured interviews were completed with verbally expressive children (n= 7) and nurses of participating children (n= 13). Significant differences among children were found in response to the clown intervention relative to television exposure. Physiologically, changes in ANS signals occurred either more frequently or in different patterns. Emotionally, children's (self) and nurses' (observed) reports of mood were elevated positively. Behaviorally, children exhibited more positive and fewer negative facial expressions and vocalizations of emotion during the clown intervention. Content and themes extracted from the interviews corroborated these findings. The results suggest that this popular psychosocial intervention has a direct and positive impact on hospitalized children. This pilot study contributes to the current understanding of the importance of alternative approaches in promoting well-being within healthcare settings.

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State-wide Genomic Epidemiology Investigations of COVID-19 Infections in Healthcare Workers: Insights for Future Pandemic Preparedness

10.1101/2021.09.08.21263057 ◽

2021 ◽

Author(s):

Anne E Watt ◽

Norelle L Sherry ◽

Patiyan Andersson ◽

Courtney R Lane ◽

Sandra Johnson ◽

...

Keyword(s):

Healthcare Workers ◽

Genomic Analysis ◽

Epidemiological Data ◽

Pandemic Preparedness ◽

Transmission Networks ◽

Healthcare Facilities ◽

Multiple Introductions ◽

Genomic Epidemiology ◽

Sequencing Coverage ◽

Healthcare Settings

Background COVID-19 has resulted in many infections in healthcare workers (HCWs) globally. We performed state-wide SARS-CoV-2 genomic epidemiological investigations to identify HCW transmission dynamics and provide recommendations to optimise healthcare system preparedness for future outbreaks. Methods Genome sequencing was attempted on all COVID-19 cases in Victoria, Australia. We combined genomic and epidemiologic data to investigate the source of HCW infections across multiple healthcare facilities (HCFs) in the state. Phylogenetic analysis and fine-scale hierarchical clustering were performed for the entire Victorian dataset including community and healthcare cases. Facilities provided standardised epidemiological data and putative transmission links. Findings Between March and October 2020, approximately 1,240 HCW COVID-19 infection cases were identified; 765 are included here. Genomic sequencing was successful for 612 (80%) cases. Thirty-six investigations were undertaken across 12 HCFs. Genomic analysis revealed that multiple introductions of COVID-19 into facilities (31/36) were more common than single introductions (5/36). Major contributors to HCW acquisitions included mobility of staff and patients between wards and facilities, and characteristics and behaviours of individual patients including super-spreading events. Key limitations at the HCF level were identified. Interpretation Genomic epidemiological analyses enhanced understanding of HCW infections, revealing unsuspected clusters and transmission networks. Combined analysis of all HCWs and patients in a HCF should be conducted, supported by high rates of sequencing coverage for all cases in the population. Established systems for integrated genomic epidemiological investigations in healthcare settings will improve HCW safety in future pandemics.

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Workplace Violence against Healthcare Workers in Health Services Organizations

10.35455/brk12345678910 ◽

2020 ◽

Vol 4 (1) ◽

Author(s):

Bernice Kennedy ◽

◽

Chrishonda Kennedy-Baker

Keyword(s):

Health Services ◽

Workplace Violence ◽

Healthcare Workers ◽

The United States ◽

Occupational Hazards ◽

Safe Environment ◽

Work Settings ◽

Healthcare Environment ◽

Healthcare Settings ◽

Healthcare Administrators

The healthcare environment is one of the most complex and dangerous occupational hazards for healthcare workers, especially nurses. The complexity of a culture of patient-related violence and the nature of their jobs place healthcare workers at risk for violence on the job. Workplace violence is a profoundly serious issue and continues to be a growing problem in the United States. This paper is a brief literature review of workplace violence against healthcare workers in health services organizations. These sections will be discussed (a) common workplaces where violence occurs; (b)types of workplace violence; (c)workplace violence against healthcare workers in health services organizations displayed in a conceptual model; (d) mental health and physiological problems of workplace violence on healthcare workers; (e) cost of workplace violence in health services organizations; and (e) strategies for prevention. Healthcare administrators are obligated to provide a safe environment for patients and staff. However, numerous guidelines have been developed, workplace violence continues to be at an increased rate. Continuous research studies are needed to improve the safety of healthcare workers in their diverse work settings. Also, more research is needed in healthcare settings with limited research.

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Nurse managers’ perspectives on working with everyday ethics in long-term care

Nursing Ethics ◽

10.1177/0969733020935958 ◽

2020 ◽

Vol 27 (8) ◽

pp. 1669-1680

Author(s):

Siri Andreassen Devik ◽

Hilde Munkeby ◽

Monica Finnanger ◽

Aud Moe

Keyword(s):

Nursing Care ◽

Healthcare Workers ◽

Nurse Managers ◽

Home Nursing ◽

Term Care ◽

Ethical Competence ◽

Healthcare Settings ◽

Ethical Care ◽

The Individual ◽

Home Nursing Care

Background: Nurse managers are expected to continuously ensure that ethical standards are met and to support healthcare workers’ ethical competence. Several studies have concluded that nurses across various healthcare settings lack the support needed to provide safe, compassionate and competent ethical care. Objective: The aim of this study was to explore and understand how nurse managers perceive their role in supporting their staff in conducting ethically sound care in nursing homes and home nursing care. Design and participants: Qualitative individual interviews were performed with 10 nurse managers with human resources responsibilities for healthcare workers in four nursing home wards and six home nursing care districts. Content analysis was used to analyse the data. Ethical considerations: The Norwegian Centre for Research Data granted permission for this study. Findings: The analysis resulted in seven subcategories that were grouped into three main categories: managers’ perception of the importance of the role, managers’ experiences of exercising the role and managers’ opportunities to fulfil the role. Challenges with conceptualizing ethics were highlighted, as well as lack of applicable tools or time and varying motivation among employees. Discussion: The leaders tended to perceive ethics as a ‘personal matter’ and that the need for and benefit of ethical support (e.g., ethics reflection) depended on individuals’ vulnerability, attitudes, commitment and previous experiences. The managers did not seem to distinguish between their own responsibility to support ethical competence and the responsibility of the individual employee to provide ethical care. Conclusions: Our findings suggest that nurse managers need support themselves, both to understand and to carry out their responsibilities to foster their staffs’ ethical conduct. Supporting staff in conducting ethically sound care requires more than organizing meeting places for ethical reflection; it also requires greater awareness and understanding of what ethical leadership means.

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