Practical strategies to reduce nosocomial transmission to healthcare professionals providing respiratory care to patients with COVID-19

Abstract Coronavirus disease (COVID-19) is an emerging viral infection that is rapidly spreading across the globe. SARS-CoV-2 belongs to the same coronavirus class that caused respiratory illnesses such as severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). During the SARS and MERS outbreaks, many frontline healthcare workers were infected when performing high-risk aerosol-generating medical procedures as well as when providing basic patient care. Similarly, COVID-19 disease has been reported to infect healthcare workers at a rate of ~ 3% of cases treated in the USA. In this review, we conducted an extensive literature search to develop practical strategies that can be implemented when providing respiratory treatments to COVID-19 patients, with the aim to help prevent nosocomial transmission to the frontline workers.

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Exploring the factors associated with the mental health of frontline healthcare workers during the COVID-19 pandemic in Cyprus

PLoS ONE ◽

10.1371/journal.pone.0258475 ◽

2021 ◽

Vol 16 (10) ◽

pp. e0258475

Author(s):

Konstantinos Kapetanos ◽

Stella Mazeri ◽

Despo Constantinou ◽

Anna Vavlitou ◽

Marios Karaiskakis ◽

...

Keyword(s):

Mental Health ◽

Healthcare Workers ◽

Healthcare Professionals ◽

Maslach Burnout Inventory ◽

Sample Population ◽

Negative Effects ◽

Cross Sectional ◽

Logistic Regression Models ◽

Factors Associated ◽

Frontline Healthcare Workers

Introduction The spread of COVID-19 into a global pandemic has negatively affected the mental health of frontline healthcare-workers. This study is a multi-centre, cross-sectional epidemiological study that uses nationwide data to assess the prevalence of stress, anxiety, depression and burnout among health care workers managing COVID-19 patients in Cyprus. The study also investigates the mechanism behind the manifestation of these pathologies, as to allow for the design of more effective protective measures. Methods Data on the mental health status of the healthcare workers were collected from healthcare professionals from all over the nation, who worked directly with Covid patients. This was done via the use of 64-item, self-administered questionnaire, which was comprised of the DASS21 questionnaire, the Maslach Burnout Inventory and a number of original questions. Multivariable logistic regression models were used to investigate factors associated with each of the mental health measures. Results The sample population was comprised of 381 healthcare professionals, out of which 72.7% were nursing staff, 12.9% were medical doctors and 14.4% belonged to other occupations. The prevalence of anxiety, stress and depression among the sample population were 28.6%, 18.11% and 15% respectively. The prevalence of burnout was 12.3%. This was in parallel with several changes in the lives of the healthcare professionals, including; working longer hours, spending time in isolation and being separated from family. Discussion This study indicates that the mental health of a significant portion of the nation’s workforce is compromised and, therefore, highlights the need for an urgent intervention particularly since many countries, including Cyprus, are suffering a second wave of the pandemic. The identified risk factors should offer guidance for employers aiming to protect their frontline healthcare workers from the negative effects of the COVID-19 pandemic.

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One-Year Update on Salivary Diagnostic of COVID-19

Frontiers in Public Health ◽

10.3389/fpubh.2021.589564 ◽

2021 ◽

Vol 9 ◽

Author(s):

Douglas Carvalho Caixeta ◽

Stephanie Wutke Oliveira ◽

Leia Cardoso-Sousa ◽

Thulio Marquez Cunha ◽

Luiz Ricardo Goulart ◽

...

Keyword(s):

Healthcare Professionals ◽

Close Contact ◽

False Negative ◽

Nasopharyngeal Swab ◽

Frontline Workers ◽

Non Invasive ◽

Negative Results ◽

False Negative Results ◽

One Year ◽

Frontline Healthcare Workers

Background: Coronavirus disease 2019 (COVID-19) is a global health problem, which is challenging healthcare worldwide. In this critical review, we discussed the advantages and limitations in the implementation of salivary diagnostic platforms of COVID-19. The diagnostic test of COVID-19 by invasive nasopharyngeal collection is uncomfortable for patients and requires specialized training of healthcare professionals in order to obtain an appropriate collection of samples. Additionally, these professionals are in close contact with infected patients or suspected cases of COVID-19, leading to an increased contamination risk for frontline healthcare workers. Although there is a colossal demand for novel diagnostic platforms with non-invasive and self-collection samples of COVID-19, the implementation of the salivary platforms has not been implemented for extensive scale testing. Up to date, several cross-section and clinical trial studies published in the last 12 months support the potential of detecting SARS-CoV-2 RNA in saliva as a biomarker for COVID-19, providing a self-collection, non-invasive, safe, and comfortable procedure. Therefore, the salivary diagnosis is suitable to protect healthcare professionals and other frontline workers and may encourage patients to get tested due to its advantages over the current invasive methods. The detection of SARS-CoV-2 in saliva was substantial also in patients with a negative nasopharyngeal swab, indicating the presence of false negative results. Furthermore, we expect that salivary diagnostic devices for COVID-19 will continue to be used with austerity without excluding traditional gold standard specimens to detect SARS-CoV-2.

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WILLINGNESS TO WORK AMONGST AUSTRALIAN FRONTLINE HEALTHCARE WORKERS DURING AUSTRALIA’S FIRST WAVE OF COVID-19 COMMUNITY TRANSMISSION: RESULTS OF AN ONLINE SURVEY

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2021.288 ◽

2021 ◽

pp. 1-24

Author(s):

Michella Hill ◽

Erin Smith ◽

Brennen Mills

Keyword(s):

Public Health ◽

Healthcare Workers ◽

Online Survey ◽

Healthcare Professionals ◽

Protective Equipment ◽

Online Questionnaire ◽

Public Health Emergencies ◽

Community Transmission ◽

Frontline Healthcare Workers ◽

Insight Into

Abstract Objectives The majority of research investigating healthcare workers’ (HCWs) willingness to work during public health emergencies asks participants to forecast their perceptions based on hypothetical emergencies, rather than in response to actual public health emergencies they have experienced. This research explored frontline HCWs willingness to work during Australia’s first wave of the COVID-19 pandemic among frontline HCWs. Methods Participants (n=580) completed an online questionnaire regarding their willingness to work during the pandemic. Results Forty-two percent of participants reported being less willing to work during the pandemic compared to before. Availability of personal protective equipment (PPE), concern expressed by family members, and viral exposure were significant barriers. One-third of participants disagreed that some level of occupational risk for exposure to infectious disease was acceptable. One-quarter of participants had received communications from their workplace concerning obligations to work during COVID-19. Conclusions The COVID-19 pandemic has impacted Australian frontline HCWs’ willingness to work. Scarcity of PPE and exposure to the virus were the most cited reasons impacting on willingness to work. Appropriate policies and practices should be implemented and communicated efficiently to frontline HCW’s. This research provides insight into the lived experiences of Australian healthcare professionals’ willingness to work during a pandemic.

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Slovak healthcare workers’ lived experience of conscience

Human Affairs ◽

10.1515/humaff-2016-0015 ◽

2016 ◽

Vol 26 (2) ◽

Author(s):

Radoslav Blaho

Keyword(s):

Lived Experience ◽

Healthcare Workers ◽

Defense Mechanisms ◽

Healthcare Professionals ◽

External Factors ◽

Medical Procedures ◽

Structured Interviews

AbstractThis paper investigates the meaning of conscience in providing healthcare and Slovak healthcare workers’ lived experience of conscience. It draws on data from semi-structured interviews with eleven healthcare professionals. The data was analyzed using a phenomenological hermeneutic interpretation. Two main themes relating to the lived experience of conscience were derived—preserving one’s conscience integrity, by satisfying one’s conscience in order to sustain it, using defense mechanisms for protection, following one’s inner conviction, and respecting the patient’s individuality and having a troubled conscience in relation to external factors, medical procedures and options, and demands by the authorities. The results are discussed in relation to the literature.

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Experiences of frontline healthcare workers and their views about support during COVID-19 and previous pandemics: a systematic review and qualitative meta-synthesis

BMC Health Services Research ◽

10.1186/s12913-021-06917-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jo Billings ◽

Brian Chi Fung Ching ◽

Vasiliki Gkofa ◽

Talya Greene ◽

Michael Bloomfield

Keyword(s):

Mental Health ◽

Healthcare Workers ◽

Psychosocial Support ◽

Grey Literature ◽

Opportunity To Learn ◽

Health Impact ◽

Frontline Workers ◽

Health And Wellbeing ◽

Frontline Healthcare Workers ◽

The Impact

Abstract Background Healthcare workers across the world have risen to the demands of treating COVID-19 patients, potentially at significant cost to their own health and wellbeing. There has been increasing recognition of the potential mental health impact of COVID-19 on frontline workers and calls to provide psychosocial support for them. However, little attention has so far been paid to understanding the impact of working on a pandemic from healthcare workers’ own perspectives or what their views are about support. Methods We searched key healthcare databases (Medline, PsychINFO and PubMed) from inception to September 28, 2020. We also reviewed relevant grey literature, screened pre-print servers and hand searched reference lists of key texts for all published accounts of healthcare workers’ experiences of working on the frontline and views about support during COVID-19 and previous pandemics/epidemics. We conducted a meta-synthesis of all qualitative results to synthesise findings and develop an overarching set of themes and sub-themes which captured the experiences and views of frontline healthcare workers across the studies. Results This review identified 46 qualitative studies which explored healthcare workers’ experiences and views from pandemics or epidemics including and prior to COVID-19. Meta-synthesis derived eight key themes which largely transcended temporal and geographical boundaries. Participants across all the studies were deeply concerned about their own and/or others’ physical safety. This was greatest in the early phases of pandemics and exacerbated by inadequate Personal Protective Equipment (PPE), insufficient resources, and inconsistent information. Workers struggled with high workloads and long shifts and desired adequate rest and recovery. Many experienced stigma. Healthcare workers’ relationships with families, colleagues, organisations, media and the wider public were complicated and could be experienced concomitantly as sources of support but also sources of stress. Conclusions The experiences of healthcare workers during the COVID-19 pandemic are not unprecedented; the themes that arose from previous pandemics and epidemics were remarkably resonant with what we are hearing about the impact of COVID-19 globally today. We have an opportunity to learn from the lessons of previous crises, mitigate the negative mental health impact of COVID-19 and support the longer-term wellbeing of the healthcare workforce worldwide.

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Medical Students Volunteering during COVID-19 Pandemic: Synopsis of Some Student-led Initiatives in Nepal

Journal of Nepal Medical Association ◽

10.31729/jnma.6703 ◽

2021 ◽

Vol 59 (240) ◽

Author(s):

Pragyan Basnet ◽

Anjali Joshi

Keyword(s):

Medical Students ◽

Personal Protective Equipment ◽

General Public ◽

Healthcare Workers ◽

Healthcare Professionals ◽

Protective Equipment ◽

Telemedicine Service ◽

Raising Awareness ◽

Security Personnel ◽

Frontline Healthcare Workers

The efforts shown by healthcare professionals, security personnel and the general public in fighting Coronavirus Disease 2019 pandemic is highly appreciable. Medical students are future healthcare professionals and have the opportunity to volunteer and help their seniors fight Coronavirus Disease 2019 pandemic. In Nepal, we as medical students are contributing by raising awareness about Coronavirus Disease 2019 along with some innovative initiatives which are Project Personal Protective Equipment, Project Telemedicine and the ″Donate Plasma, Help Defeat COVID-19″ Campaign. Since we were able to support thousands of frontline healthcare workers with personal protective equipment and reduce burden in hospitals by providing telemedicine service, we believe such volunteering and initiations from medical students can be an inspiration for all students for future crises.

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Perceptions of mHealth applications and features to support psychosocial wellbeing among frontline healthcare workers involved in the COVID-19 pandemic response (Preprint)

10.2196/preprints.26282 ◽

2020 ◽

Author(s):

Sungwon Yoon ◽

Hendra Goh ◽

Gayathri Devi Nadarajan ◽

Sharon Sung ◽

Irene Teo ◽

...

Keyword(s):

Peer Support ◽

Healthcare Workers ◽

Peer Interactions ◽

Structured Interviews ◽

Frontline Workers ◽

Psychosocial Wellbeing ◽

Tangible Rewards ◽

Visual Materials ◽

Frontline Healthcare Workers ◽

Future Work

BACKGROUND Frontline healthcare workers are experiencing a myriad of physical and psychosocial challenges amid the COVID-19 pandemic. There is growing recognition that digital technologies have the potential for improving wellbeing of frontline workers. However, there is limited development of wellness interventions using mHealth technology. More importantly, little research has been conducted on how frontline workers perceive mHealth-based support to promote their wellbeing. OBJECTIVE This study aimed to explore frontline workers’ experience of conventional psychological wellness programs and their perceptions of the usefulness of mHealth apps and features for promoting wellbeing. It also sought to identify factors that influence uptake and retention of a mHealth-based wellness program. METHODS We conducted semi-structured interviews using purposive sampling with frontline workers involved in the COVID-19 response. Various visual materials, collated from existing mHealth app features, were presented to facilitate discussion. Interviews were audio-recorded and transcribed verbatim. Thematic analysis based on grounded theory was undertaken. Themes were subsequently mapped to key nudge strategies, commonly used for mHealth development, to assess participants’ preferences for particular features and their reasoning. RESULTS A total of 42 frontline workers participated in twelve one-to-one interviews or focus group discussions. Frontline workers generally had limited mental health literacy to identify their own psychological problems and liked the reminders functionality to track their mood over time. A personalised goal-setting feature (tailoring) and in-app resources were generally valued while frequent coaching and messages (framing) were seen as a distraction. The majority desired a built-in chat with a counsellor (guidance) for reasons of accessibility and protection of privacy. Very few participants appreciated a gamification function. Frontline workers commonly reported the need for ongoing social support and desired access to in-app peer support community (social influence). There were concerns regarding potential risks from virtual peer interactions. Intrinsic motivational factors, mHealth app technicality and tangible rewards were identified as critical for uptake and retention. CONCLUSIONS Our study highlights the potential of mHealth with relevant features to safeguard the wellbeing of frontline workers. Future work should focus on developing a non-intrusive and personalised mHealth app with in-app counselling, peer support to improve wellbeing, and tangible and extrinsic rewards to foster continued use.

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Psychological Distress Among Healthcare Professionals During the Early Stages of the COVID-19 Outbreak in Low Resource Settings: A Cross-Sectional Study in Bangladesh

Frontiers in Public Health ◽

10.3389/fpubh.2021.701920 ◽

2021 ◽

Vol 9 ◽

Author(s):

Md. Riad Hossain ◽

Muhammad Mainuddin Patwary ◽

Rabeya Sultana ◽

Matthew H. E. M. Browning

Keyword(s):

Psychological Distress ◽

Healthcare Workers ◽

Healthcare Professionals ◽

Cross Sectional Study ◽

Public Institution ◽

Sectional Study ◽

Cross Sectional ◽

Psychological States ◽

Frontline Workers ◽

Early Stages

The COVID-19 pandemic has been very destructive to and compromised the functioning of all nations' public health systems. In the absence of a vaccine, healthcare workers have been employed to relentlessly fight against COVID-19. The psychological status of healthcare workers during the pandemic in countries with limited resources, notably Bangladesh, remains unclear. The present study aimed to investigate the psychological states of frontline and non-frontline Bangladeshi healthcare workers during the early stages of the COVID-19 outbreak. An online cross-sectional study was conducted from May 5 to 31, 2020 with 203 respondents. Psychological states were measured with a self-reported numerical scale of fear, the Generalized Anxiety Disorder (GAD-7) scale, and the Patient Health Questionnaire (PHQ-9). The prevalence rates of fear, anxiety, and depression were 60.6, 71.9, and 55.2%, respectively. Compared to non-frontline workers, frontline workers reported higher rates of anxiety (79.0 vs. 67.2%) and depression (65.4 vs. 48.4%). Multivariate logistic regression models showed that working in a public institution, being employed for <5 years, and being over-worked were risk factors for developing psychological distress. Our findings emphasize the need for timely psychological interventions to support the mental well-being of healthcare professionals in Bangladesh.

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The Silent Pandemic: The Psychological Burden on Frontline Healthcare Workers during COVID-19

Psychiatry Journal ◽

10.1155/2021/2906785 ◽

2021 ◽

Vol 2021 ◽

pp. 1-11

Author(s):

Luise J. Froessl ◽

Yazan Abdeen

Keyword(s):

Mental Health ◽

Risk Factors ◽

Healthcare Workers ◽

Psychological Impact ◽

High Stress ◽

Psychological Burden ◽

Additional Risk ◽

Frontline Workers ◽

Preventative Measures ◽

Frontline Healthcare Workers

This narrative review explores the full scope of harmful psychological effects of the COVID-19 (Coronavirus Disease of 2019) pandemic on FLHCWs (Frontline healthcare workers). Additionally, we highlight the risk factors for worse outcomes. A literature review identified 24 relevant papers included in this synthesis. The majority of studies reported a high number of mental health conditions in HCWs (Healthcare workers) overall. Working in the frontline setting was repeatedly identified as an independent risk factor for poorer mental health. Additional risk factors, such as gender, occupational pressure, and low level of support from hospital administration, family, and the community, were also commonly identified. In the past, defined interventions have been shown to mitigate the psychological impact of high-stress situations on frontline workers. This review is aimed at identifying individuals at higher risk to help effectively target preventative measures in future stress situations in our healthcare system.

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Healthcare Workers’ Experiences of Working on the Frontline and Views About Support During COVID-19 and Previous Pandemics: A Systematic Review and Qualitative Meta-Synthesis

10.21203/rs.3.rs-322448/v1 ◽

2021 ◽

Author(s):

Jo Billings ◽

Brian Chi Fung Ching ◽

Vasiliki Gkofa ◽

Talya Greene ◽

Michael Bloomfield

Keyword(s):

Mental Health ◽

Healthcare Workers ◽

Psychosocial Support ◽

Grey Literature ◽

Opportunity To Learn ◽

Health Impact ◽

Frontline Workers ◽

Health And Wellbeing ◽

Frontline Healthcare Workers ◽

The Impact

Abstract Background: Healthcare workers across the world have risen to the demands of treating COVID-19 patients, potentially at significant cost to their own health and wellbeing. There has been increasing recognition of the potential mental health impact of COVID-19 on frontline workers and calls to provide psychosocial support for them. However, little attention has so far been paid to understanding the impact of working on a pandemic from healthcare workers’ own perspectives or what their views are about support. Methods: We searched key healthcare databases (Medline, PsychINFO and PubMed), reviewed relevant grey literature, screened pre-print servers and hand searched reference lists of key texts for all published accounts of healthcare workers’ experiences of working on the frontline and views about support during COVID-19 and previous pandemics/epidemics. Final searches took place on September 28, 2020. We conducted a meta-synthesis of all qualitative results to synthesise findings and develop an overarching set of themes and sub-themes which captured the experiences and views of frontline healthcare workers across the studies. Results: This review identified 46 qualitative studies which explored healthcare workers’ experiences and views from pandemics or epidemics including and prior to COVID-19. Meta-synthesis derived eight key themes which largely transcended temporal and geographical boundaries. Participants across all the studies were deeply concerned about their own and/or others’ physical safety. This was greatest in the early phases of pandemics and exacerbated by inadequate PPE, insufficient resources, and inconsistent information. Workers struggled with high workloads and long shifts and desired adequate rest and recovery. Many experienced stigma. Healthcare workers’ relationships with families, colleagues, organisations, media and the wider public were complicated and nuanced and could be experienced concomitantly as sources of support but also sources of stress. Conclusions: The experiences of healthcare workers during the COVID-19 pandemic are not unprecedented; the themes that arose from previous pandemics and epidemics were remarkably resonant with what we are hearing about the impact of COVID-19 globally today. We have an opportunity to learn from the lessons of these previous crises, mitigate the negative mental health impact of COVID-19 and support the longer-term wellbeing of the healthcare workforce worldwide.

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