scholarly journals Reconstructing transmission chains of SARS-CoV-2 amid multiple outbreaks in a geriatric acute-care hospital

2022 ◽  
Author(s):  
Mohamed Abbas ◽  
Anne Cori ◽  
Samuel Cordey ◽  
Florian Laubscher ◽  
Tomás Robalo Nunes ◽  
...  
Keyword(s):  
Acute Care ◽  
Healthcare Workers ◽  
Acute Care Hospital ◽  
Credible Interval ◽  
Care Hospital ◽  
Sequencing Data ◽  
Genetic Sequencing ◽  
Modelling Framework ◽  
Pandemic Wave ◽  
Geriatric Settings

Background There is ongoing uncertainty regarding transmission chains and the respective roles of healthcare workers (HCWs) and elderly patients in nosocomial outbreaks of severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) in geriatric settings. Methods We performed a retrospective cohort study including patients with nosocomial coronavirus disease 2019 (COVID–19) in four outbreak–affected wards, and all SARS–CoV–2 RT–PCR positive HCWs from a Swiss university–affiliated geriatric acute–care hospital that admitted both Covid–19 and non–Covid–19 patients during the first pandemic wave in Spring 2020. We combined epidemiological and genetic sequencing data using a Bayesian modelling framework, and reconstructed transmission dynamics of SARS–CoV–2 involving patients and HCWs, in order to determine who infected whom. We evaluated general transmission patterns according to type of case (HCWs working in dedicated Covid–19 cohorting wards: HCWcovid; HCWs working in non–Covid–19 wards where outbreaks occurred: HCWoutbreak; patients with nosocomial Covid–19: patientnoso) by deriving the proportion of infections attributed to each type of case across all posterior trees and comparing them to random expectations. Results During the study period (March 1 to May 7, 2020) we included 180 SARS–CoV–2 positive cases: 127 HCWs (91 HCWcovid, 36 HCWoutbreak) and 53 patients. The attack rates ranged from 10–19% for patients, and 21% for HCWs. We estimated that there were 16 importation events (3 patients, 13 HCWs) that jointly led to 16 secondary cases. Most patient–to–patient transmission events involved patients having shared a ward (97.6%, 95% credible interval [CrI] 90.4–100%), in contrast to those having shared a room (44.4%, 95%CrI 27.8–62.5%). Transmission events tended to cluster by type of case: patientnoso were almost twice as likely to be infected by other patientnoso than expected (observed:expected ratio 1.91, 95%CrI 1.08 – 4.00, p = 0.02); similarly, HCWoutbreak were more than twice as likely to be infected by other HCWoutbreak than expected (2.25, 95%CrI 1.00–8.00, p = 0.04). The proportion of infectors of HCWcovid were as expected as random. The proportions of high transmitters (≥2 secondary cases) were significantly higher among HCWoutbreak than patientnoso in the late phases (26.2% vs. 13.4%, p<2.2e–16) of the outbreak. Conclusions Most importation events were linked to HCW. Unexpectedly, transmission between HCWcovid was more limited than transmission between patients and HCWoutbreak. This highlights gaps in infection control and suggests possible areas of improvements to limit the extent of nosocomial transmission.

scholarly journals SARS-CoV-2 exposure, symptoms and seroprevalence in healthcare workers in Sweden

2020 ◽  
Vol 11 (1) ◽  
Author(s):  
Ann-Sofie Rudberg ◽  
Sebastian Havervall ◽  
Anna Månberg ◽  
August Jernbom Falk ◽  
Katherina Aguilera ◽  
...  
Keyword(s):  
Occupational Exposure ◽  
Occupational Health ◽  
Acute Care ◽  
Odds Ratio ◽  
Healthcare Workers ◽  
Acute Care Hospital ◽  
Care Hospital ◽  
Patient Contact ◽  
Igg Antibodies ◽  
Time Period

Abstract SARS-CoV-2 may pose an occupational health risk to healthcare workers. Here, we report the seroprevalence of SARS-CoV-2 antibodies, self-reported symptoms and occupational exposure to SARS-CoV-2 among healthcare workers at a large acute care hospital in Sweden. The seroprevalence of IgG antibodies against SARS-CoV-2 was 19.1% among the 2149 healthcare workers recruited between April 14th and May 8th 2020, which was higher than the reported regional seroprevalence during the same time period. Symptoms associated with seroprevalence were anosmia (odds ratio (OR) 28.4, 95% CI 20.6–39.5) and ageusia (OR 19.2, 95% CI 14.3–26.1). Seroprevalence was also associated with patient contact (OR 2.9, 95% CI 1.9–4.5) and covid-19 patient contact (OR 3.3, 95% CI 2.2–5.3). These findings imply an occupational risk for SARS-CoV-2 infection among healthcare workers. Continued measures are warranted to assure healthcare workers safety and reduce transmission from healthcare workers to patients and to the community.

Rate of Healthcare Worker–Patient Interaction and Hand Hygiene Opportunities in an Acute Care Setting

2014 ◽  
Vol 35 (3) ◽  
pp. 225-230 ◽  
Author(s):  
Laura Goodliffe ◽  
Kelsey Ragan ◽  
Michael Larocque ◽  
Emily Borgundvaag ◽  
Sophia Khan ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hand Hygiene ◽  
Healthcare Worker ◽  
Acute Care ◽  
Healthcare Workers ◽  
Acute Care Hospital ◽  
Care Hospital ◽  
Factors Affecting ◽  
Patient Interactions

Objective.Identify factors affecting the rate of hand hygiene opportunities in an acute care hospital.Design.Prospective observational study.Setting.Medical and surgical in-patient units, medical-surgical intensive care unit (MSICU), neonatal intensive care unit (NICU), and emergency department (ED) of an academic acute care hospital from May to August, 2012.Participants.Healthcare workers.Methods.One-hour patient-based observations measured patient interactions and hand hygiene opportunities as defined by the “Four Moments for Hand Hygiene.” Rates of patient interactions and hand hygiene opportunities per patient-hour were calculated, examining variation by room type, healthcare worker type, and time of day.Results.During 257 hours of observation, 948 healthcare worker-patient interactions and 1,605 hand hygiene opportunities were identified. Moments 1, 2, 3, and 4 comprised 42%, 10%, 9%, and 39% of hand hygiene opportunities. Nurses contributed 77% of opportunities, physicians contributed 8%, other healthcare workers contributed 11%, and housekeeping contributed 4%. The mean rate of hand hygiene opportunities per patient-hour was 4.2 for surgical units, 4.5 for medical units, 5.2 for ED, 10.4 for NICU, and 13.2 for MSICU (P < .001). In non-ICU settings, rates of hand hygiene opportunities decreased over the course of the day. Patients with transmission-based precautions had approximately half as many interactions (rate ratio [RR], 0.55 [95% confidence interval (CI), 0.37-0.80]) and hand hygiene opportunities per hour (RR, 0.47 [95% CI, 0.29-0.77]) as did patients without precautions.Conclusions.Measuring hand hygiene opportunities across clinical settings lays the groundwork for product use-based hand hygiene measurement. Additional work is needed to assess factors affecting rates in other hospitals and health care settings.

scholarly journals Scabies outbreak among healthcare workers in a German acute care hospital

2017 ◽  
Vol 18 (4) ◽  
pp. 189-192 ◽  
Author(s):  
Rasmus Leistner ◽  
Dirk Buchwald ◽  
Marc Beyer ◽  
Sandra Philipp
Keyword(s):  
Acute Care ◽  
Healthcare Workers ◽  
Multivariable Analysis ◽  
Acute Care Hospital ◽  
Index Patient ◽  
Physical Contact ◽  
P Value ◽  
Care Hospital ◽  
Increased Risk ◽  
Crusted Scabies

Background: This article reports on a scabies outbreak among healthcare workers (HCW) in an acute care hospital. The outbreak was associated with a patient suffering from a chronic skin disease that was later diagnosed as crusted scabies. Objective: The objective was to determine the outbreak drivers and define a prevention strategy against future outbreaks. Methods: All staff that had contact with the patient were treated with 5% permethrin ointment. An interdisciplinary outbreak investigation team was established. The team conducted a questionnaire-based case-control study. Findings: After the permethrin treatment, no further case was found. Twenty-seven HCWs who had contact with the index patient answered the questionnaire (response rate 73%). The outbreak questionnaire revealed 13 cases of secondary scabies among HCWs. In the multivariable analysis, a lack of glove use (odds ratio [OR], 9.8; P value = 0.036) and frequent close physical contact (OR, 8.151; P value = 0.038) were associated with increased risk of scabies acquisition. Discussion: The scabies outbreak was most likely driven by three factors: an index patient with crusted scabies; a delayed diagnosis of this patient; and close physical contact without gloves during his hospital stay. The use of disposable gloves for patients with unclear dermatological diagnosis have the potential to limit future scabies outbreaks.

Use of Electronic Health Record Documentation by Healthcare Workers in an Acute Care Hospital System

2014 ◽  
Vol 59 (2) ◽  
pp. 130-144 ◽  
Author(s):  
Daleen Aragon Penoyer ◽  
Kendall H. Cortelyou-Ward ◽  
Alice M. Noblin ◽  
Tim Bullard ◽  
Steve Talbert ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Acute Care ◽  
Healthcare Workers ◽  
Acute Care Hospital ◽  
Health Record ◽  
Care Hospital ◽  
Hospital System ◽  
Electronic Health

scholarly journals Estimated number of N95 respirators needed for healthcare workers in acute-care hospitals during the coronavirus disease 2019 (COVID-19) pandemic

2021 ◽  
pp. 1-9
Author(s):  
Patrick T. Wedlock ◽  
Kelly J. O’Shea ◽  
Madellena Conte ◽  
Sarah M. Bartsch ◽  
Samuel L. Randall ◽  
...  
Keyword(s):  
United States ◽  
Resource Allocation ◽  
Acute Care ◽  
Healthcare Workers ◽  
Acute Care Hospital ◽  
The United States ◽  
Care Hospital ◽  
Single Use ◽  
N95 Respirators ◽  
Admission Prevalence

Abstract Objective: Due to shortages of N95 respirators during the coronavirus disease 2019 (COVID-19) pandemic, it is necessary to estimate the number of N95s required for healthcare workers (HCWs) to inform manufacturing targets and resource allocation. Methods: We developed a model to determine the number of N95 respirators needed for HCWs both in a single acute-care hospital and the United States. Results: For an acute-care hospital with 400 all-cause monthly admissions, the number of N95 respirators needed to manage COVID-19 patients admitted during a month ranges from 113 (95% interpercentile range [IPR], 50–229) if 0.5% of admissions are COVID-19 patients to 22,101 (95% IPR, 5,904–25,881) if 100% of admissions are COVID-19 patients (assuming single use per respirator, and 10 encounters between HCWs and each COVID-19 patient per day). The number of N95s needed decreases to a range of 22 (95% IPR, 10–43) to 4,445 (95% IPR, 1,975–8,684) if each N95 is used for 5 patient encounters. Varying monthly all-cause admissions to 2,000 requires 6,645–13,404 respirators with a 60% COVID-19 admission prevalence, 10 HCW–patient encounters, and reusing N95s 5–10 times. Nationally, the number of N95 respirators needed over the course of the pandemic ranges from 86 million (95% IPR, 37.1–200.6 million) to 1.6 billion (95% IPR, 0.7–3.6 billion) as 5%–90% of the population is exposed (single-use). This number ranges from 17.4 million (95% IPR, 7.3–41 million) to 312.3 million (95% IPR, 131.5–737.3 million) using each respirator for 5 encounters. Conclusions: We quantified the number of N95 respirators needed for a given acute-care hospital and nationally during the COVID-19 pandemic under varying conditions.

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