Psychological distress experienced by physicians and nurses at a tertiary care center in Lebanon during the COVID-19 outbreak

The COVID-19 outbreak has had a significant mental health toll on healthcare workers in Lebanon. We examined pandemic-related psychological distress among healthcare workers in a tertiary care medical center. One hundred and fifty participants completed an online questionnaire. About half showed a high risk of acute distress (58.7%) on the GHQ-28, while most (89.3%) scored low/moderate stress on the PSS-10. The IES-R revealed concern for post-traumatic stress in one-third of participants, significantly in nurses ( p = 0.008) and those living with vulnerable individuals ( p = 0.030). Mental health history did not increase the risk. Our findings highlight the need for early targeted interventions during the pandemic.

Download Full-text

A Prolonged Outbreak of Methicillin-Resistant Staphylococcus aureus in the Burn Unit of a Tertiary Medical Center

Infection Control and Hospital Epidemiology ◽

10.1017/s0195941700003520 ◽

1996 ◽

Vol 17 (12) ◽

pp. 798-802 ◽

Cited By ~ 2

Author(s):

Patricia A. Meier ◽

Cheryl D. Carter ◽

Sarah E. Wallace ◽

Richard J. Hollis ◽

Michael A. Pfaller ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Infection Control ◽

Healthcare Workers ◽

Medical Center ◽

Tertiary Care ◽

Chromosomal Dna ◽

Methicillin Resistant ◽

Persistent Problem ◽

Tertiary Care Medical Center ◽

Burn Unit

AbstractObjective:To report an outbreak of methicillin-resistant Staphylococcus aureus (MRSA) in our burn unit and the steps we used to eradicate the organism.Design And Setting:Outbreak investigation in the burn unit of a 900-bed tertiary-care medical center.Outbreak:Between March and June 1993, MRSA was isolated from 10 patients in our burn unit. All isolates had identical antibiograms and chromosomal DNA patterns.Control Measures:Infection control personnel encouraged healthcare workers to wash their hands after each patient contact. The unit cohorted all infected or colonized patients, placed each affected patient in isolation, and, if possible, transferred the patient to another unit. Despite these measures, new cases occurred. Infection control personnel obtained nares cultures from 56 healthcare workers, 3 of whom carried the epidemic MRSA strain. One healthcare worker cared for six affected patients, and one cared for five patients. We treated the three healthcare workers with mupirocin. Subsequently, no additional patients became colonized or infected with the epidemic MRSA strain.Conclusions:The outbreak ended after we treated healthcare workers who carried the epidemic strain with mupirocin. This approach is not appropriate in all settings. However, we felt it was justified in this case because of a persistent problem after less intrusive measures.

Download Full-text

Impact of Bordetella pertussis Exposures on a Massachusetts Tertiary Care Medical System

Infection Control and Hospital Epidemiology ◽

10.1086/518352 ◽

2007 ◽

Vol 28 (6) ◽

pp. 708-712 ◽

Cited By ~ 20

Author(s):

Iva Zivna ◽

Diana Bergin ◽

Joanne Casavant ◽

Sally Fontecchio ◽

Susan Nelson ◽

...

Keyword(s):

Bordetella Pertussis ◽

Healthcare Workers ◽

Close Contact ◽

Medical Center ◽

Tertiary Care ◽

Medical System ◽

Secondary Case ◽

Tertiary Care Medical Center ◽

Outbreak Investigations ◽

The Impact

Objective.To assess the impact of outbreaks of Bordetella pertussis infection on a tertiary care medical system.Design.Retrospective study.Setting.Academic tertiary care medical center and affiliated ambulatory care settings.Subjects.All patients and healthcare workers (HCWs) who were in close contact with patients with laboratory-confirmed cases of B. pertussis infection from October 1, 2003, through September 30, 2004.Intervention.Direct and indirect medical center costs were determined, including low and high estimates of time expended in the evaluation and management of exposed patients and HCWs during outbreak investigations of laboratory-confirmed cases of B. pertussis infection.Results.During this period, 20 primary and 3 secondary laboratory-confirmed cases of B. pertussis infection occurred, with 2 primary pertussis cases and 1 secondary case occurring in HCWs. Outbreak investigations prompted screening of 353 medical center employees. Probable or definitive exposure was identified for 296 HCWs, and 287 subsequently received treatment or prophylaxis for B. pertussis infection. Direct medical center costs for treatment and prophylaxis were $13,416 and costs for personnel time were $19,500-$31,190. Indirect medical center costs for time lost from work were $51,300-$52,300. The total cost of these investigations was estimated to be $85,066-$98,456.Conclusions.Frequent B. pertussis exposures had a major impact on our facility. Given the impact of exposures on healthcare institutions, routine vaccination for HCWs may be beneficial.

Download Full-text

Fear, Anxiety, Stress, and Depression of novel coronavirus (COVID-19) pandemic among patients and their healthcare workers

10.1101/2021.05.28.21258006 ◽

2021 ◽

Author(s):

Ashwin Parchani ◽

K Vidhya ◽

Prasan Kumar Panda ◽

Vikram Singh Rawat ◽

Yogesh Arvind Bahurupi ◽

...

Keyword(s):

Mental Health ◽

Healthcare Workers ◽

Mental Health Problems ◽

Care Center ◽

Tertiary Care ◽

Psychological State ◽

Health Issues ◽

Novel Coronavirus ◽

Frontline Healthcare Workers ◽

High Degree

Background Disease pandemics are known to cause psychological distress. The ensuing mental health issues are not only restricted to the patients and their relatives/friends but affect the healthcare workers (HCWs) as well. Our study aims to assess these psychological trends during the COVID-19 pandemic between the two most affected population groups, that is, patients and frontline healthcare workers. Methods A survey questionnaire including scales to assess fear, anxiety, stress, depression - PSS 10, and DASS 21 was distributed and sent to all COVID-19 suspected/confirmed individuals and healthcare workers at a tertiary care center along with a second visit after 14 days of answering the first questionnaire and this continued as follow up. Data were analyzed with the SPSS Version 23 using various tests of significance. Results In the community, COVID-19 patients in the age group 41-50 with respiratory tract symptoms and those who were home isolated/quarantined experienced a greater tendency of mental health problems. Healthcare workers posted in COVID-19 designated areas of the hospital displayed higher levels of stress, anxiety, and depression. Conclusion The high degree of uncertainty associated with novel pathogens has a profound effect on the psychological state of suspected/confirmed cases as well as healthcare workers. Within the community, individuals suspected of having COVID-19 display a significant mental health burden, while HCWs also experience an unprecedented amount of stress during such enduring situations.

Download Full-text

Coronavirus disease 2019 (COVID-19) vaccination uptake among healthcare workers

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2021.421 ◽

2021 ◽

pp. 1-6

Author(s):

Mayan Gilboa ◽

Ilana Tal ◽

Einav G. Levin ◽

Shoshi Segal ◽

Ana Belkin ◽

...

Keyword(s):

Healthcare Workers ◽

Medical Center ◽

Demographic Data ◽

Tertiary Care ◽

Vaccine Safety ◽

Vaccine Uptake ◽

Multivariate Logistic Regression Model ◽

Educational Backgrounds ◽

Tertiary Care Medical Center ◽

To Receive

Abstract Objective: To assess reasons for noncompliance with COVID-19 vaccination among healthcare workers (HCWs). Design: Cohort observational and surveillance study. Setting: Sheba Medical Center, a 1,600-bed tertiary-care medical center in Israel. Participants: The study included 10,888 HCWs including all employees, students, and volunteers. Intervention: The BNT162b2 mRNA COVID-19 vaccine was offered to all HCWs of the hospital. Noncompliance was assessed, and pre-rollout and post-rollout surveys were conducted. Data regarding uptake of the vaccine as well as demographic data and compliance with prior influenza vaccination were collected, and 2 surveys were distributed. The survey before the rollout pertained to the intention to receive the vaccine, and the survey after the rollout pertained to all unvaccinated HCWs regarding causes of hesitancy. Results: In the pre-rollout survey, 1,673 (47%) of 3,563 HCWs declared their intent to receive the vaccine. Overall, 8,108 (79%) HCWs received the COVID-19 vaccine within 40 days of rollout. In a multivariate logistic regression model, the factors that were significant predictors of vaccine uptake were male sex, age 40–59 years, occupation (paramedical professionals and doctors), high socioeconomic level, and compliance with flu vaccine. Among 425 unvaccinated HCWs who answered the second survey, the most common cause for hesitancy was the risk during pregnancy (31%). Conclusions: Although vaccine uptake among HCWs was higher than expected, relatively low uptake was observed among young women and those from lower socioeconomic levels and educational backgrounds. Concerns regarding vaccine safety during pregnancy were common and more data about vaccine safety, especially during pregnancy, might improve compliance.

Download Full-text

Monitoring Hand hygiene Compliance among Healthcare Workers at a Tertiary Care Center: Use of Secret Observers Is the Way Forward

Open Forum Infectious Diseases ◽

10.1093/ofid/ofx163.1023 ◽

2017 ◽

Vol 4 (suppl_1) ◽

pp. S409-S409

Author(s):

Amar Krishna ◽

Bhagyashri Navalkele ◽

Amina Pervaiz ◽

Aditya Kotecha ◽

Shahram Maroof ◽

...

Keyword(s):

Hand Hygiene ◽

Performance Feedback ◽

Healthcare Workers ◽

Hand Hygiene Compliance ◽

Medical Center ◽

Care Center ◽

Compliance Rate ◽

Tertiary Care ◽

Smartphone App ◽

Hygiene Compliance

Abstract Background Hand-hygiene (HH) is known to be the most effective way to reduce healthcare acquired conditions (HACs). Despite being a simple answer to the complex HAC issue, compliance with HH practice has been abysmal with reported compliance rate of 40% among healthcare workers (HCWs). In 2015, compliance rate with HH at Detroit Medical Center (DMC) was reported to be 100% when direct observers were used to monitor compliance. In order to confirm the previously reported compliance rates, this study used secret observers to audit HH compliance and provide performance feedback to HCWs. Methods A prospective observational study was conducted at DMC from June 2016 to December 2016. Hand hygiene committee was established comprising of Infection Prevention and Hospital leadership members. Trained medical residents were appointed as “secret observers” to provide accurate HH reporting. HH auditing was performed using the smartphone app “Speedy audits” to survey and capture the 5 moments of hand hygiene among HCWs. Compliance reports based on different professions, hospital sites, unit locations and auditors were generated using online web portal and analyzed to determine HH compliance rate. Results During the 7-month study period when secret observers were used, a total of 1229 HCWs were observed. Overall, the HH opportunity compliance rate was 31% (916 complied opportunities /2939 opportunities). Hand hygiene compliance rates drastically fell when secret observers were used (31% compared with 100% in 2015 using direct observers). Based on two major before and after patient contact indications, 1022 compliances were observed from 3343 opportunities (30.5% compliance rate). The other compliance rates were 44% before aseptic procedure, 35% after body fluid exposure and 20% after patient environment contact [Figure 1]. Based on profession, compliance rates were lowest among nurses (613/2058; 30%) and medical students (36/169; 21%) when compared with physicians (445/957; 46%). Conclusion Hand-hygiene monitoring by secret observers with use of smartphone app is a feasible and accurate way for tracking HH compliance. The advantage of generating profession-based and unit-based reports for feedback will help to promote HH awareness and improve adherence rates. Disclosures All authors: No reported disclosures.

Download Full-text

State of Mental Health of Caregivers on the Frontline during the Covid 19 Pandemic in Medical College and Tertiary Care Centers of Maharashtra

10.47363/jcbr/2021(3)126 ◽

2021 ◽

pp. 1-2

Author(s):

Anu Kant Mital ◽

◽

Alkesh Patil ◽

Mrudula Joshi ◽

◽

...

Keyword(s):

Mental Health ◽

Healthcare Workers ◽

Tertiary Care ◽

Healthcare Services ◽

Post Traumatic Stress ◽

Medical College ◽

Stress Symptoms ◽

Direct Exposure ◽

Prevalence Of Depression ◽

Tertiary Care Centers

Healthcare workers have been under immense pressure during COVID 19 pandemic. The novelty of the disease, absence of vaccine, transmission pattern of infection, unpredictable and uncertain nature of infection, unprepared healthcare services were additional factors contributing to the stress of high number of infected cases. These factors can cause significant disturbance in state of mental health of caregivers on the frontline who have direct exposure to infected patients as well as suspected with infected and quarantined individuals. The aim of the study was to evaluate the prevalence of Depression, Anxiety, Stress and Post-Traumatic Stress Symptoms experienced by healthcare workers on frontline in Mumbai and Thane, Maharashtra, India in the midst of outbreak which are the most affected cities of the Nation

Download Full-text

Incidence of Urinary Tract Infection Following Transrectal Ultrasound Guided Prostate Biopsy at a Tertiary-Care Medical Center in Lebanon

Infection Control and Hospital Epidemiology ◽

10.1086/502312 ◽

2004 ◽

Vol 25 (10) ◽

pp. 873-877 ◽

Cited By ~ 57

Author(s):

Zaher K. Otrock ◽

Gerard O. Oghlakian ◽

Mariana M. Salamoun ◽

Maurice Haddad ◽

Abdul Rahman N. Bizri

Keyword(s):

Urinary Tract ◽

Antimicrobial Prophylaxis ◽

Medical Center ◽

Care Center ◽

Tertiary Care ◽

Transrectal Ultrasound ◽

Ultrasound Guided ◽

Tertiary Care Medical Center ◽

The Mean ◽

Tract Infections

AbstractObjective:To determine the incidence of urinary tract infections (UTIs) following transrectal ultrasound guided needle biopsy of the prostate (TRUBP) and the bacteriology of these infections.Design:Retrospective evaluation of the charts and records of all patients who underwent TRUBP between June 1, 2002, and August 31, 2003.Setting:American University of Beirut Medical Center, a tertiary-care center in Lebanon.Patients:Two hundred seven patients underwent TRUBP. All received prophylactic antibiotics. One hundred twenty (58%) received ciprofloxacin alone, whereas 87 (42%) received both ciprofloxacin and gentamicin. Sixty-one patients (29.5%) had an enema prior to the procedure, whereas 146 (70.5%) did not.Results:Thirteen patients (6.3%) were admitted with UTI. All had rigors and fever on admission. Symptoms appeared at a mean of 2.7 days and the mean hospital stay was 9.2 days. The mean duration of antibiotic treatment was 23.2 days. Ten (77%) of the patients had positive bacteriology. Urine cultures were positive in 8 (61.5%) of the patients and blood cultures in 6 (46.2%). All positive cultures grew Escherichia coli resistant to ciprofloxacin, with 5 isolates producing extended-spectrum beta-lactamases.Conclusions:TRUBP continues to be associated with significant infectious complications, especially UTI. Given the increasing incidence of antibiotic resistance mainly among the Enterobacteriaceae, antimicrobial prophylaxis practices should be reevaluated and the universal administration of quinolones alone or in combination with aminoglycosides should be reconsidered.

Download Full-text

Impact of Covid-19 on the mental health of singaporean GPs: a cross-sectional study

BJGP Open ◽

10.3399/bjgpo.2021.0072 ◽

2021 ◽

pp. BJGPO.2021.0072

Author(s):

Alvin Lum ◽

Yen-Li Goh ◽

Kai Sheng Wong ◽

Junie Seah ◽

Gina Teo ◽

...

Keyword(s):

Mental Health ◽

Primary Care ◽

Mental Health Problems ◽

Demographic Data ◽

Tertiary Care ◽

Multivariate Regression Analysis ◽

Post Traumatic Stress ◽

Cross Sectional ◽

Targeted Interventions ◽

The Impact

BackgroundCovid-19 has stressed healthcare systems and workers worldwide. General practitioners (GPs), as first points-of-contact between suspected cases and the healthcare system, assume frontline roles in this crisis. While the prevalence of mental health problems and illnesses arising in healthcare workers (HCWs) from tertiary care settings during Covid-19 is well-examined,(1) the impact on GPs remains understudied.AimTo describe the prevalence and predictors of anxiety, burnout, depression, and post-traumatic stress disorder (PTSD) amongst GPs during the Covid-19 pandemicDesign & settingSurvey of GPs operating in Singapore primary care clinicsMethodGPs completed a survey which comprised of four validated psychometric instruments. Open-ended questions asked of respondents’ challenges and their envisaged support. Data were analysed with multiple logistic regression with demographic data as covariates; concepts of grounded theory were used to analyse the qualitative responses.Results257 GPs participated. 55 (21.4%) met the scales’ criteria for anxiety, 211 (82.1%) for burnout, 68 for (26.6%) for depression, and 23 (9.1%) for PTSD. Multivariate regression analysis showed working in a public primary care setting was associated with anxiety and depression. Qualitative analyses uncovered possible stressors: changes to clinical and operational practices, increased workloads, and financial difficulties.ConclusionMental health issues were found present in Singaporean GPs during the pandemic. Prevalence of anxiety, burnout and depression were found to be higher than those reported pre-Covid-19. Our findings also provide determinants of the issues which serve as possible foci for targeted interventions.

Download Full-text

Promoting COVID-19 vaccination among healthcare personnel: a multifaceted intervention at a tertiary care center in Japan

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2021.325 ◽

2021 ◽

pp. 1-26

Author(s):

Akane Takamatsu ◽

Hitoshi Honda ◽

Tomoya Kojima ◽

Kengo Murata ◽

Hilary Babcock

Keyword(s):

Medical Center ◽

Care Center ◽

Tertiary Care ◽

Vaccination Rate ◽

Multifaceted Intervention ◽

Vaccine Hesitancy ◽

Healthcare Personnel ◽

Tertiary Care Center ◽

Post Intervention ◽

Post Vaccination

Abstract Objective The COVID-19 vaccine may hold the key to ending the pandemic, but vaccine hesitancy is hindering the vaccination of healthcare personnel (HCP). Design Before-after trial Participants and setting Healthcare personnel at a 790-bed tertiary care center in Tokyo, Japan. Interventions A pre-vaccination questionnaire was administered to HCP to examine their perceptions of the COVID-19 vaccine. Then, a multifaceted intervention involving (1) distribution of informational leaflets to all HCP, (2) hospital-wide announcements encouraging vaccination, (3) a mandatory lecture, (4) an educational session about the vaccine for pregnant or breastfeeding HCP, and (5) allergy testing for HCP at risk of allergic reactions to the vaccine was implemented. A post-vaccination survey was also performed. Results Of 1,575 HCP eligible for enrollment, 1,224 (77.7%) responded to the questionnaire, 43.5% (n =533) expressed willingness to be vaccinated, 48.4% (n = 593) were uncertain, and 8.0% (n=98) expressed unwillingness to be vaccinated. The latter two groups were concerned about the vaccine’s safety rather than its efficacy. Post-intervention, the overall vaccination rate reached 89.7% (1,413/1,575), with 88.9% (614/691) of the pre-vaccination survey respondents who answered “unwilling” or “unsure” eventually receiving a vaccination. In the post-vaccination questionnaire, factors contributing to increased COVID-19 vaccination included information and endorsement of vaccination at the medical center (26.4%; 274/1,037). Conclusions The present, multifaceted intervention increased COVID-19 vaccinations among HCP at a Japanese hospital. Frequent support and provision of information were crucial for increasing the vaccination rate and may be applicable to the general population as well.

Download Full-text