414. Observed Time Burden with Nursing Practices in an Emergency Room COVID-19 Isolation Zone at a University Affiliated Hospital in Korea

Abstract Background The coronavirus disease 2019 (COVID-19) has caused great burdens on emergency room (ER) and front-line ER healthcare personnel faced with great challenges, including threats to their safety. This study aimed to provide a basis for additional workload of ER nurses who are charged with providing care for COVID-19 confirmed or suspicious cases. Table 1. Summary of Frequency and Time Burden with Nursing Practices in an Emergency Room COVID-19 Isolation Zone. Note. IV, intravenous; IM, intramuscular; ID, intradermal; SC, subcutaneous; PPE, personal protective equipment; CPR, cardiopulmonary resuscitation Methods With institutional review board approval, we recruited ER nurses who were assigned to COVID-19 isolation zone with more than 6 months’ ER work experience. After their demographic information were collected through a questionnaire, their nursing practices and practice time during their 1 shift (day or evening) were recorded by one researcher using a stopwatch and an observation form. For each observation shift, unit-related information was collected, including the numbers of hospitalized patients, admission, discharge, and transfer of patients. For each nursing practice, frequency and total time spent were analyzed using descriptive statistics with SPSS 26.0 program. Results From January 4 to February 22, 2021, a total 18 nurses (27.4 years old on average with 25.2 months of ER experience) were observed from 20 different shifts. During the observation period, the average number of nurses’ working hours was 8.27 ± 0.39 hours. A total of 6,567 tasks were monitored with 337,703 seconds (93.81 hours) of the total time spent. Infection control practices were most frequent (33.88%) followed by nursing management (27.80%), assessment and observation (11.07%), medication (10.35%), pre and post examination care(4.86%), education (4.37%), communication (4.10%), safety care (1.10%), and others (0.03; Table 1). Nursing management (e.g., nursing recording) was most time-consuming (49.29%) followed by assessment and observation (15.03%), medication (12.94%), patient education (6.10%), infection control (5.30%), and safety care (1.64%). Conclusion This study showed that infection control practices were most frequent while time spent was relatively insignificant among ER nurses in charge of COVID-19 isolation zones. Further studies for more observations or with different study designs at other ER settings are necessary to understand nurse’s burdens with COVID-19 emergency care. Disclosures All Authors: No reported disclosures

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Observed Time Burden With Isolation Precautions at Three University-Affiliated Hospitals in Korea

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.581 ◽

2020 ◽

Vol 41 (S1) ◽

pp. s86-s86

Author(s):

JaHyun Kang ◽

Omar Karlsson ◽

Bock-hui Yeon ◽

Si-Hyeon Han ◽

Jae Yeun Kim

Keyword(s):

Infection Control ◽

Science Research ◽

Healthcare Personnel ◽

Patient Treatment ◽

Observation Study ◽

Average Hospital ◽

Patient Isolation ◽

Study Results ◽

Hospital Infection Control ◽

Time Burden

Background: Isolation precautions (IPs; ie, patient isolation with transmission-based precautions) are essential in hospital infection control interventions to prevent the transmission of healthcare-associated infections. Because IPs require healthcare personnel (HCP) to use personal protective equipment (PPE; eg, gown, gloves, and mask) to enter patient isolation rooms and perform hand hygiene (HH) frequently, IPs are often regarded as cumbersome tasks and may lead to fewer HCP visits. This observation study examined the time burden of IPs (ie, PPE use and HH) from time spent on HCP tasks, including patient treatment and care, in patient isolation rooms. Methods: With institutional review board approval, participating hospitals were recruited. At each hospital, assigned infection control nurses observed HCP tasks at patient isolation rooms of interest and recorded each task’s duration, using a stopwatch or timer and an observation form. For each observation block (ie, a duty period at 1 observation unit, regardless of the number of observed isolation rooms), unit-related information was collected, including the numbers of hospitalized patients, admission patients, discharge patients, isolation patients, and nurses. For each block, IP proportions were calculated by total time spent on IP divided by the total time spent on all tasks. Descriptive statistics, t test, ANOVA, and regression analyses were conducted using STATA version 16.0 software. Results: Three university-affiliated hospitals (838 average hospital beds, range 811–855) participated from April 2 to May 18, 2019 (for 7–9 days). In total, 2,901 tasks were monitored and the total time spent was 164,973 seconds; most tasks were done by nurses (89.2%) and females (86.8%). Although the most time-intensive task was procedures (eg, intravenous infusion) followed by medication, PPE use was the most frequent task followed by HH (Table 1). Regarding IP proportions, an overall average of 23.6% of total task time was spent on IPs (16.1% for PPE use and 7.5% for HH) in patient isolation rooms (Table 2). Notably, tasks in the tuberculosis isolation room of hospital B showed a greater HH proportion (13.7%) than PPE proportion (13.5%) because HCP usually use N95 masks only. Wards, compared to intensive care units (ICUs), showed higher PPE proportions (19.2%), potentially due to PPE stock in the nurse station and less PPE education compared to ICUs. Conclusions: Our study results demonstrated the substantial amount of time spent on IP compliance among all task durations in patient isolation rooms. To improve IP compliance, this time burden needs to be considered with greater system support, such as more nursing staff.Funding: This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (Grant no. 2017R1D1A1B03036377).Disclosures: None

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420. Emergency Nurses’ Experiences over 1 Year of the COVID-19 Pandemic: A Qualitative Study

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab466.620 ◽

2021 ◽

Vol 8 (Supplement_1) ◽

pp. S310-S311

Author(s):

Ki Rog Lee ◽

JaHyun Kang

Keyword(s):

Infection Control ◽

Emergency Room ◽

Social Life ◽

Emerging Infectious Diseases ◽

Medical Personnel ◽

Tertiary Hospital ◽

Work Experiences ◽

Emergency Nurses ◽

Psychological Burden ◽

Institutional Review

Abstract Background At the frontline of fighting against the coronavirus disease 2019 (COVID-19) pandemic, emergency room (ER) nurses are faced with various challenges throughout the provision of emergency care for incoming patients without knowing their COVID-19 status. However, little is known about their work burden, exhaustion, and psychological distress in the pandemic. Therefore, to provide basic data for effective counterstrategies against future emerging infectious diseases in the ER, this study aims to understand ER nurses’ COVID-19 work experiences in depth at one tertiary hospital over 1 year. Table 1. Summary of Qualitative Responses Regarding Emergency Room Nurses’ COVID-19 Pandemic Experience Methods This study was conducted at a 2,715-bed tertiary hospital in Seoul, Korea. Using a purposeful sampling method, we recruited 20 nurses who have worked for more than 1 year in the ER and have capacity for independent care for COVID-19 patients. With institutional review board approval, one-on-one individual, in-depth interviews were completed using a semi-structured questionnaire from February 13 to March 25, 2021. After recording and transcribing interviews, the narrative data were analyzed using a thematic analysis method. Results The 20 participants were 29.9 years old on average with 69.2 months’ clinical experience. The overarching theme was derived as ‘COVID-19 highlighted the importance of ER’s infection control and ER nurses’ professional dedication’ covering 6 sub-themes and 16 concepts (Table 1). Sub-themes were ‘psychological burden of handling COVID-19 patients directly’, ‘unprecedented changes for ER’s response to the pandemic’, ‘revealing hospital’s lack of support for ER’, ‘withdrawal from social life as ER nurses’, ‘re-illuminating nurses’ calling for their occupation’, and ‘planning for the post COVID-19 era’. Conclusion ER nurses experienced challenges from their drastically changed tasks, received poor compensation from the hospital, and felt pressure from social expectations towards medical personnel. However, nurses showed enough dedication towards their jobs, considered pandemic experience as a valuable asset to their future career, and maintained a positive attitude towards difficulties in ER. Providing comprehensive support for ER nurses is necessary to improve ER infection control to respond to the pandemic. Disclosures All Authors: No reported disclosures

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Modeling Effectiveness of Testing Strategies to Prevent Coronavirus Disease 2019 (COVID-19) in Nursing Homes—United States, 2020

Clinical Infectious Diseases ◽

10.1093/cid/ciab110 ◽

2021 ◽

Cited By ~ 2

Author(s):

Isaac See ◽

Prabasaj Paul ◽

Rachel B Slayton ◽

Molly K Steele ◽

Matthew J Stuckey ◽

...

Keyword(s):

Nursing Homes ◽

Infection Control ◽

Relative Sensitivity ◽

Turnaround Time ◽

Potential Effect ◽

Infection Control Practice ◽

Healthcare Personnel ◽

Test Frequency ◽

Testing Strategies ◽

Serial Testing

Abstract Background Identifying asymptomatic individuals early through serial testing is recommended to control coronavirus disease 2019 (COVID-19) in nursing homes, both in response to an outbreak (“outbreak testing” of residents and healthcare personnel) and in facilities without outbreaks (“nonoutbreak testing” of healthcare personnel). The effectiveness of outbreak testing and isolation with or without nonoutbreak testing was evaluated. Methods Using published SARS-CoV-2 transmission parameters, the fraction of SARS-CoV-2 transmissions prevented through serial testing (weekly, every 3 days, or daily) and isolation of asymptomatic persons compared with symptom-based testing and isolation was evaluated through mathematical modeling using a Reed-Frost model to estimate the percentage of cases prevented (ie, “effectiveness”) through either outbreak testing alone or outbreak plus nonoutbreak testing. The potential effect of simultaneous decreases (by 10%) in the effectiveness of isolating infected individuals when instituting testing strategies was also evaluated. Results Modeling suggests that outbreak testing could prevent 54% (weekly testing with 48-hour test turnaround) to 92% (daily testing with immediate results and 50% relative sensitivity) of SARS-CoV-2 infections. Adding nonoutbreak testing could prevent up to an additional 8% of SARS-CoV-2 infections (depending on test frequency and turnaround time). However, added benefits of nonoutbreak testing were mostly negated if accompanied by decreases in infection control practice. Conclusions When combined with high-quality infection control practices, outbreak testing could be an effective approach to preventing COVID-19 in nursing homes, particularly if optimized through increased test frequency and use of tests with rapid turnaround.

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Healthcare personnel experiences implementing carbapenem-resistant Enterobacterales infection control measures at a ventilator-capable skilled nursing facility—A qualitative analysis

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2021.265 ◽

2021 ◽

pp. 1-7

Author(s):

Katharina R. Rynkiewich ◽

Jinal Makhija ◽

Mary Carl M. Froilan ◽

Ellen C. Benson ◽

Alice Han ◽

...

Keyword(s):

Infection Control ◽

Multidrug Resistant ◽

Control Measures ◽

Healthcare Personnel ◽

Skilled Nursing ◽

Infection Control Measures ◽

Carbapenem Resistant ◽

Resident Care ◽

Semistructured Interviews ◽

Self Protection

Abstract Objective: Ventilator-capable skilled nursing facilities (vSNFs) are critical to the epidemiology and control of antibiotic-resistant organisms. During an infection prevention intervention to control carbapenem-resistant Enterobacterales (CRE), we conducted a qualitative study to characterize vSNF healthcare personnel beliefs and experiences regarding infection control measures. Design: A qualitative study involving semistructured interviews. Setting: One vSNF in the Chicago, Illinois, metropolitan region. Participants: The study included 17 healthcare personnel representing management, nursing, and nursing assistants. Methods: We used face-to-face, semistructured interviews to measure healthcare personnel experiences with infection control measures at the midpoint of a 2-year quality improvement project. Results: Healthcare personnel characterized their facility as a home-like environment, yet they recognized that it is a setting where germs were ‘invisible’ and potentially ‘threatening.’ Healthcare personnel described elaborate self-protection measures to avoid acquisition or transfer of germs to their own household. Healthcare personnel were motivated to implement infection control measures to protect residents, but many identified structural barriers such as understaffing and time constraints, and some reported persistent preference for soap and water. Conclusions: Healthcare personnel in vSNFs, from management to frontline staff, understood germ theory and the significance of multidrug-resistant organism transmission. However, their ability to implement infection control measures was hampered by resource limitations and mixed beliefs regarding the effectiveness of infection control measures. Self-protection from acquiring multidrug-resistant organisms was a strong motivator for healthcare personnel both outside and inside the workplace, and it could explain variation in adherence to infection control measures such as a higher hand hygiene adherence after resident care than before resident care.

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FAKTOR-FAKTOR YANG MEMPENGARUHI PENDAPATAN PEKERJA PADA KERAJINAN TENUN LELUNAKAN DI KECAMATAN MARGA KABUPATEN TABANAN

GANEC SWARA ◽

10.35327/gara.v13i1.62 ◽

2019 ◽

Vol 13 (1) ◽

pp. 50

Author(s):

NI MADE TAMAN AYUK

Keyword(s):

Work Experience ◽

Working Hours ◽

Education Level ◽

Test Results ◽

Positive Real ◽

Level Of Education ◽

Positive Effect

The purpose of this study was to find out: 1) the influence of working hours, education level and work experience partially on the income of workers of soft weaving craftsmen in Marga Subdistrict, Tabanan Regency, 2) the effect of working hours, education level and simultaneous work experience on income workers of soft weaving crafts in Marga Subdistrict, Tabanan Regency. The test results show that: 1) working hours have a significantly positive positive effect on the income of workers of soft weaving craftsmen, with t count greater than t table (3.875> 1.696) and the significance is smaller than 0.05 (0.001 <0.05), 2) the level of education has no significant effect on the income of workers of soft weaving craftsmen, with t count smaller than t table (0.645 <1.696) and its significance is greater than 0.05 (0.524> 0.05) and 3) influential work experience partially positive real to the income of workers of soft weaving craftsmen in Marga Subdistrict, Tabanan Regency, with t count greater than t table (2,297> 1,696) and the significance is smaller than 0.05 (0.029 <0.05). Simultaneously working hours, level of education and work experience significantly influence income. This can be seen from the F value of 18.195 greater than the F table value of 2.91

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HIV: Infection Control Issues For Oral Healthcare Personnel

The Journal of Contemporary Dental Practice ◽

10.5005/jcdp-8-3-1 ◽

2007 ◽

Vol 8 (3) ◽

pp. 1-12

Author(s):

Geza T. Terezhalmy ◽

Michaell A. Huber

Keyword(s):

Occupational Exposure ◽

Infection Control ◽

Hiv Infection ◽

Healthcare Setting ◽

Essential Elements ◽

Needlestick Injury ◽

Healthcare Personnel ◽

Emotional Impact ◽

Control Plan ◽

Exposure Prevention

Abstract Aim To present the essential elements of an infection control/exposure control plan in the oral healthcare setting with emphasis on HIV infection. Methods and Materials A comprehensive review of the literature was conducted with special emphasis on HIV-related infection control issues in the oral healthcare setting. Results Currently available knowledge related to HIV-related infection control issues is supported by data derived from well-conducted trials or extensive, controlled observations, or, in the absence of such data, by best-informed, most authoritative opinion available. Conclusion Essential elements of an effective HIV-related infection control plan include: (1) education and training related to the etiology and epidemiology of HIV infection and exposure prevention; (2) plans for the management of oral healthcare personnel potentially exposed to HIV and for the follow-up of oral healthcare personnel exposed to HIV; and (3) a policy for work restriction of HIV-positive oral healthcare personnel. Clinical Significance While exposure prevention remains the primary strategy for reducing occupational exposure to HIV, knowledge about potential risks and concise written procedures that promote a seamless response following occupational exposure can greatly reduce the emotional impact of an accidental needlestick injury. Citation Huber MA, Terezhalmy GT. HIV: Infection Control Issues For Oral Healthcare Personnel. J Contemp Dent Pract 2007 March;(8)3:001-012.

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Citywide preparedness for a pandemic: A crosssectional survey of knowledge, attitudes, and practices about respiratory infection prevention in Bogotá, Colombia

Biomédica ◽

10.7705/biomedica.5526 ◽

2020 ◽

Vol 40 (Supl. 2) ◽

pp. 159-165

Author(s):

Jorge Alberto Cortés ◽

Pilar Espitia ◽

Yuliet Liliana Rosero-Lasso

Keyword(s):

Infection Control ◽

Healthcare Workers ◽

Respiratory Infections ◽

Healthcare Personnel ◽

Local Health Authority ◽

Local Health ◽

Attitudes And Practices ◽

Adequate Knowledge ◽

Level Of Knowledge ◽

Knowledge Attitudes And Practices

Introduction: Healthcare personnel plays an important role in the prevention of acute respiratory infections in hospital settings.Objective: Our aim was to establish the level of knowledge about respiratory virus infections and the attitudes and practices among healthcare workers, leaders of infection control committees in hospitals of Bogotá, Colombia.Materials and methods: We used a self-administered questionnaire of 28 items during the monthly meeting sponsored by the local health authority. “Yes or no” and “true or false” questions were applied to measure knowledge. Attitudes and practices were measured with a Likert-type scale according to the agreement degree.Results: We surveyed 70 healthcare workers. Respondents demonstrated a good level of knowledge as 80% of them answered correctly more than five questions. A total of 54.4% showed a low degree of agreement when asked if their institutions have the policy to stay home when they are sick with respiratory symptoms and 67.1% never or rarely remain at home under such conditions.Conclusion: Healthcare worker leaders of infection control committees in Bogotá’s ospitals have adequate knowledge about the prevention of seasonal respiratory viruses. There is a need for implementing urgent sick leave policies as a measure to prevent the spread of potential coronavirus infections in hospitals.

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Assessment of Knowledge and Practices of Standard Precaution against Blood Borne Pathogens among Doctors and Nurses at Adult Emergency Room in Addis Ababa, Ethiopia

Emergency Medicine International ◽

10.1155/2019/2926415 ◽

2019 ◽

Vol 2019 ◽

pp. 1-8 ◽

Cited By ~ 5

Author(s):

Yohanis Asmr ◽

Lemlem Beza ◽

Hywot Engida ◽

Tariku Bekelcho ◽

Netsanet Tsegaye ◽

...

Keyword(s):

Infection Control ◽

Emergency Room ◽

Addis Ababa ◽

Public Hospitals ◽

Good Knowledge ◽

Standard Precautions ◽

Practice Level ◽

Standard Precaution ◽

The Mean ◽

Doctors And Nurses

Background. Standard precautions are infection control techniques against pathogenic microorganisms that are present in human blood and can cause disease in humans. Objective. This study aims to assess knowledge and practice of standard precautions against blood borne pathogens among doctors and nurses in adult emergency room, Addis Ababa, Ethiopia. Methods. Institutional based cross sectional study was conducted from February to March 2018. A total of 128 study participants selected from four public hospitals were enrolled in this study. Data were collected using standardized pretested questionnaire and thencoded, entered, checked for completeness, and analyzed using SPSS version-23 statisticalsoftware. Chi-square test was used to measure the association between variables. P values <0.05 were taken as statistically significant. Result. The mean knowledge score of standard precaution measures was 10.3 out of 14 knowledge items. Out of 32 doctors, 93.8% (n=30) have good knowledge and out of 91 nurses, 86.8% (n=79) have good knowledge. The mean practice level of the study subjects was 8.5 out of 12 practice items. Majority (73.6%) of nurses have good practice level than doctors (21.8%). Knowledge level was significantly associated with the presence of infection control officer, infection control guideline, and washing hands before touching patients. Profession, training, and the presence of infection control guideline in emergency room were significantly associated with practice level of respondents (P<0.05). Conclusion. Both nurses and doctors have good knowledge of standard precaution measures. However, nurses have better practice level than doctors. Orientation during employment and continuous training programs should be provided for the newly employed health workers. In addition sustainable supply systems should be available in each hospital management.

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