Effective perioperative scoring in orthopedic surgery  to prevent Covid-19 infection

BackgroundThe pandemic has placed health-care workers (HCW) under an unprecedented strain where surgeries are being delayed and health care workers’ deaths because of COVID-19 are prominent and causing staff shortages. An effective, fast, and concise approach to preoperative screening is very much needed. Hospitals are suggested to develop their own algorithm to minimize delays and complications. The objective of this study was to optimize HCW safety by developing a working system based on the hospital’s service capability in treating orthopedic surgeries. Methods A retrospective study was conducted involving 305 HCW. Data were collected on the application of a novel elective and emergency orthopedic surgery clinical pathway and scoring method based on questionnaires, and laboratory and radiographic chest examinations for several months to ensure the safety of HCW. HCW COVID-19 status was routinely checked as the indicator of HCW’s safety. Results Mean age of all patients was 47.0 ± 22.41 years. The screening process was done in a series of questionnaires and laboratory examinations, with the majority of patients (82 or 35.9%) having a score of 0. Patients with a score of 3 or more and testing positive for COVID-19 were immediately referred to a hospital having adequate facilities to prevent delays. There were 51 patients (16.7%) with positive rapid test results, and 21 patients (6.8%) with positive PCR tests. There were 4 (1.3%) COVID-19 positive HCW. Conclusions Despite COVID-19 being a new threat, we have shown that developing an effective perioperative clinical pathway could eventually optimize healthcare worker safety.

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Point-of-care diagnostics: needs of African health care workers and their role combating global antimicrobial resistance

International Journal of STD & AIDS ◽

10.1177/0956462418807112 ◽

2019 ◽

Vol 30 (4) ◽

pp. 404-410

Author(s):

Rosalind Parkes-Ratanshi ◽

Ruth Kikonyogo ◽

Yu-Hsiang Hsieh ◽

Edith Nakku-Joloba ◽

Yukari C Manabe ◽

...

Keyword(s):

Health Care ◽

Sexually Transmitted Infections ◽

Health Care Workers ◽

Response Rate ◽

Point Of Care ◽

Rapid Test ◽

Wait Time ◽

Sexually Transmitted ◽

Care Workers ◽

Email Survey

Point-of-care tests (POCTs) offer the opportunity for increased diagnostic capacity in resource-limited settings, where there is lack of electricity, technical capacity, reagents, and infrastructure. Understanding how POCTs are currently used and determining what health care workers (HCWs) need is key to development of appropriate tests. In 2016, we undertook an email survey of 7584 HCWs who had received training at the Infectious Diseases Institute, Uganda, in a wide variety of courses. HCWs were contacted up to three times and asked to complete the survey using Qualtrics software. Of 555 participants answering the survey (7.3% response rate), 62% completed. Ninety-one percent were from Uganda and 50.3% were male. The most commonly-used POCTs were pregnancy tests (74%), urine dipstick (71%), syphilis rapid test (66%), and Gram stain (41%). The majority (74%) practiced syndromic diagnosis for sexually transmitted infections/HIV. Lack of availability of POCTs, increased patient wait time, and lack of training were the leading barriers for POCT use. Increasing POCT availability and training could improve uptake of POCTs for sexually transmitted infections in Africa and decrease syndromic management. This could reduce overtreatment and slow the emergence of antibiotic resistance. This is the first published email survey of HCWs in Uganda; mechanisms to increase the response rate should be evaluated.

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Seroprevalence of SARS-CoV-2 (COVID-19) among Health Care Workers in Three Health Facilities of Yaounde, Center Region of Cameroon

European Journal of Medical and Health Sciences ◽

10.24018/ejmed.2021.3.6.1109 ◽

2021 ◽

Vol 3 (6) ◽

pp. 89-94

Author(s):

Philippe Salomon Nguwoh ◽

Akenji Blaise Mboringong ◽

Joseph Fokam ◽

Christian Ngounouh Taheu ◽

Ibrahima Halilou ◽

...

Keyword(s):

Health Care ◽

Health Care Workers ◽

Clinical Signs ◽

Rapid Test ◽

Cross Sectional Study ◽

Health Facilities ◽

Cross Sectional ◽

Face To Face ◽

Care Workers ◽

History Of

Introduction: Coronavirus Disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) first appeared in December 2019 in Wuhan, China and has subsequently become a worldwide pandemic. During the pandemic, health care workers (HCWs) were very exposed to COVID-19 infected patients. The aim of this study was to determine seroprevalence of SARS-CoV-2 (COVID-19) among HCWs in three health facilities of Yaounde. Methods: A cross-sectional study involving 368 HCWs was conducted from January 18th to February 13th, 2021, in three health facilities located in city of Yaounde. Data of study participants were collected by face-to-face interviews using standard questionnaire. Blood samples were collected in labelled dry tubes and analyzed using Rapid Diagnostic Test (RDT) cassettes (Abbott PanbioTMCOVID-19 IgG/IgM Rapid Test Device). The data collected was analyzed using Epi info version 7. Any value of p <0.05 was considered statistically significant. Results: The average age was 30.25 (SD±10.43) years old, range from 21 to 72 years old. Overall, the positivity rates of IgM, IgG and IgM+IgG were 6.79% (n=25), 17.93% (n=66) and 1.09% (n=4) respectively. Multivariate analysis showed that, the rate of IgM positivity was highest in laboratory personnel (χ2= 7.99, p=0.3) and IgG (χ2= 8.50, p=0.29), IgM+IgG (χ2= 1.92, p=0.26) respectively in pharmacy and clinical personnel. The clinical signs such as fever (˃38°C) or history of fever was statistically significant with IgM (χ2=11.71, p= 0.0006) while, sore throat was statistically significant associated with IgM (χ2= 14.3, p= 0.0008) and IgG (χ2= 6.33, p= 0.04). Conclusion: The results of this study reveal a high seroprevalence of circulation of the virus in hospital milieu in Yaounde suggesting the continuation of the COVID-19 « Track-Test-Treat » system to break the chain of transmission.

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Health care workers’ experiences of workplace incidents that posed a risk of patient and worker injury: a critical incident technique analysis

BMC Health Services Research ◽

10.1186/s12913-021-06517-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Emma Nilsing Strid ◽

Charlotte Wåhlin ◽

Axel Ros ◽

Susanne Kvarnström

Keyword(s):

Health Care ◽

Health Care Workers ◽

Organizational Support ◽

Critical Incident ◽

Negative Emotions ◽

Critical Incident Technique ◽

Two Dimensions ◽

Worker Safety ◽

Active Management ◽

Care Workers

Abstract Background Health care workers (HCWs) are at high risk of occupational injuries and approximately 10–15% of patients are affected by an adverse event during their hospital stay. There is scarce scientific literature about how HCWs manage these risks in practice and what support they need. This knowledge is needed to improve safety for patients and HCWs. This study explores HCWs’ experiences of workplace incidents that led to injury or posed a risk of patient and worker injury, with focus on HCWs’ emotions and actions. Methods This study employed a qualitative design using the critical incident technique. Semi-structured individual interviews were held with 34 HCWs from three regions in Sweden. Data were analysed using inductive category development. Results Altogether 71 workplace incidents were reported. The analysis of two dimensions – the emotions HCWs feel and the actions team members and managers take when a workplace incident occurs – yielded two categories each: Anxiety during the incident, Persistent distress after the incident, Team interplay for safety actions and Support and ratification from managers and colleagues. Health care workers risked their own safety and health to provide patient safety. Teamwork and trustful relationships were critical for patient and worker safety. Support and validation from colleagues and managers were important for closure; unsatisfactory manager response and insufficient opportunities to debrief the incident could lead to persistent negative emotions. Participants described insecurity and fear, sadness over being injured at work, and shame and self-regret when the patient or themselves were injured. When the workplace had not taken the expected action, they felt anger and resignation, often turning into long-term distress. Conclusions Work situations leading to injury or risk of patient and worker injury are emotionally distressing for HCWs. Team interplay may facilitate safe and dynamic practices and help HCWs overcome negative emotions. Organizational support is imperative for individual closure. For safety in health care, employers need to develop strategies for active management of risks, avoiding injuries and providing support after an injury.

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Seroprevalence of COVID-19 in Niger State

10.1101/2020.08.04.20168112 ◽

2020 ◽

Cited By ~ 3

Author(s):

Hussaini Majiya ◽

Mohammed Aliyu-Paiko ◽

Vincent Tochukwu Balogu ◽

Dickson Achimugu Musa ◽

Ibrahim Maikudi Salihu ◽

...

Keyword(s):

Health Care ◽

Health Care Workers ◽

Herd Immunity ◽

Age Groups ◽

Rapid Test ◽

Sampling Strategy ◽

Cross Sectional Study ◽

The State ◽

Cross Sectional ◽

Care Workers

Coronavirus Disease 2019 (COVID-19) Pandemic is ongoing, and to know how far the virus has spread in Niger State, Nigeria, a pilot study was carried out to determine the COVID-19 seroprevalence, patterns, dynamics, and risk factors in the state. A cross sectional study design and clustered-stratified-Random sampling strategy were used. COVID-19 IgG and IgM Rapid Test Kits (Colloidal gold immunochromatography lateral flow system) were used to determine the presence or absence of antibodies to SARS-CoV-2 in the blood of sampled participants across Niger State as from 26th June 2020 to 30th June 2020. The test kits were validated using the blood samples of some of the NCDC confirmed positive and negative COVID-19 cases in the State. COVID-19 IgG and IgM Test results were entered into the EPIINFO questionnaire administered simultaneously with each test. EPIINFO was then used for both the descriptive and inferential statistical analyses of the data generated. The seroprevalence of COVID-19 in Niger State was found to be 25.41% and 2.16% for the positive IgG and IgM respectively. Seroprevalence among age groups, gender and by occupation varied widely. A seroprevalence of 37.21% was recorded among health care workers in Niger State. Among age groups, COVID-19 seroprevalence was found to be in order of 30-41 years (33.33%) > 42-53 years (32.42%) > 54-65 years (30%) > 66 years and above (25%) > 6-17 years (19.20%) > 18-29 years (17.65%) > 5 years and below (6.66%). A seroprevalence of 27.18% was recorded for males and 23.17% for females in the state. COVID-19 asymptomatic rate in the state was found to be 46.81%. The risk analyses showed that the chances of infection are almost the same for both urban and rural dwellers in the state. However, health care workers and those that have had contact with person (s) that travelled out of Nigeria in the last six (6) months are twice ( 2 times) at risk of being infected with the virus. More than half (54.59%) of the participants in this study did not practice social distancing at any time since the pandemic started. Discussions about knowledge, practice and attitude of the participants are included. The observed Niger State COVID-19 seroprevalence means that the herd immunity for COVID-19 is yet to be achieved and the population is still susceptible for more infection and transmission of the virus. If the prevalence stays as reported here, the population will definitely need COVID-19 vaccines when they become available. Niger State should fully enforce the use of face/nose masks and observation of social/physical distancing in gatherings including religious gatherings in order to stop or slow the spread of the virus.

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Health Care Workers’ Experiences of Workplace Incidents that Posed a Risk of Patient and Worker Injury: A Critical Incident Technique Analysis

10.21203/rs.3.rs-72305/v1 ◽

2020 ◽

Author(s):

Emma Nilsing Strid ◽

Charlotte Wåhlin ◽

Axel Ros ◽

Susanne Kvarnström

Keyword(s):

Health Care ◽

Health Care Workers ◽

Organizational Support ◽

Critical Incident ◽

Negative Emotions ◽

Critical Incident Technique ◽

Two Dimensions ◽

Worker Safety ◽

Active Management ◽

Care Workers

Abstract Background Health care workers (HCWs) are at high risk of occupational injuries and approximately 10-15% of patients are affected by an adverse event during their hospital stay. There is scarce scientific literature about how HCWs manage these risks in practice and what support they need. This knowledge is needed to improve safety for patients and HCWs. This study explores HCWs’ experiences of workplace incidents that led to injury or posed a risk of patient and worker injury, with focus on HCWs’ actions and emotions.Methods This study employed a qualitative design using the critical incident technique. Semi-structured individual interviews were held with 34 HCWs from three regions in Sweden. Data were analysed using inductive category development. Results Altogether 71 workplace incidents were reported. The analysis of two dimensions – actions HCWs take and emotions they feel when a workplace incident occurs – yielded two main areas each: HCWs’ actions, actions by the team and managers, anxiety during the incident, and persistent distress after the incident. Health care workers risked their own safety and health to provide patient safety. Teamwork and trustful relationships were critical for patient and worker safety. Support and validation from colleagues and managers were important for closure; unsatisfactory manager response and insufficient opportunities to debrief the incident could lead to persistent negative emotions. Participants described insecurity and fear, sadness over being injured at work, and shame and self-regret when the patient or themselves were injured. When the workplace had not taken the expected action, they felt anger and resignation, often turning into long-term distress. Conclusions Work situations leading to injury or risk of patient and worker injury are emotionally distressing for HCWs. Team interplay may facilitate safe and dynamic practices and help HCWs overcome negative emotions. Organizational support is imperative for individual closure. For safety in health care, employers need to develop strategies for active management of risks, avoiding injuries and providing support after an injury.

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Using Behavioral Theory to Enhance Occupational Safety and Health: Applications to Health Care Workers

American Journal of Lifestyle Medicine ◽

10.1177/1559827619896979 ◽

2020 ◽

pp. 155982761989697

Author(s):

Rebecca J. Guerin ◽

David A. Sleet

Keyword(s):

Health Care ◽

Behavior Change ◽

Health Care Workers ◽

Occupational Safety ◽

Behavioral Science ◽

Occupational Safety And Health ◽

Worker Safety ◽

Individual Level ◽

Safety And Health ◽

Care Workers

Work-related morbidity and mortality are persistent public health problems across all US industrial sectors, including health care. People employed in health care and social services are at high risk for experiencing injuries and illnesses related to their work. Social and behavioral science theories can be useful tools for designing interventions to prevent workplace injuries and illnesses and can provide a roadmap for investigating the multilevel factors that may hinder or promote worker safety and health. Specifically, individual-level behavioral change theories can be useful in evaluating the proximal, person-related antecedents (such as perceived behavioral control) that influence work safety outcomes. This article (1) provides a brief overview of widely used, individual-level behavior change theories and examples of their application to occupational safety and health (OSH)–related interventions that involve the health care community; (2) introduces an integrated theory of behavior change and its application to promoting the OSH of health care workers; and (3) discusses opportunities for application of individual-level behavior change theory to OSH research and practice activities involving health care workers. The use of behavioral science to consider the role of individual behaviors in promoting health and preventing disease and injury provides a necessary complement to structural approaches to protecting workers in the health care industry.

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Management of donations of personal protective equipment in response to the massive shortage during the COVID-19 health crisis: providing quality equipment to health care workers

Antimicrobial Resistance and Infection Control ◽

10.1186/s13756-021-01028-0 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Guillaume Cambien ◽

Jérémy Guihenneuc ◽

Xavier Fouassin ◽

Olivier Castel ◽

Anne Bousseau ◽

...

Keyword(s):

Health Care ◽

Health Care Workers ◽

Personal Protective Equipment ◽

Quality Care ◽

International Standards ◽

Worker Safety ◽

Protective Equipment ◽

Stock Management ◽

Health Crisis ◽

Care Workers

Abstract Background In the COVID-19 pandemic context, a massive shortage of personal protective equipment occurred. To increase the available stocks, several countries appealed for donations from individuals or industries. While national and international standards to evaluate personal protective equipment exist, none of the previous research studied how to evaluate personal protective equipment coming from donations to healthcare establishments. Our aim was to evaluate the quality and possible use of the personal protective equipment donations delivered to our health care establishment in order to avoid a shortage and to protect health care workers throughout the COVID-19 crisis. Methods Our intervention focused on evaluation of the quality of donations for medical use through creation of a set of assessment criteria and analysis of the economic impact of these donations. Results Between 20th March 2020 and 11th May 2020, we received 239 donations including respirators, gloves, coveralls, face masks, gowns, hats, overshoes, alcohol-based hand rubs, face shields, goggles and aprons. A total of 448,666 (86.3%) products out of the 519,618 initially received were validated and distributed in health care units, equivalent to 126 (52.7%) donations out of the 239 received. The budgetary value of the validated donations was 32,872 euros according to the pre COVID-19 prices and 122,178 euros according to the current COVID-19 prices, representing an increase of 371.7%. Conclusions By ensuring a constant influx of personal protective equipment and proper stock management, shortages were avoided. Procurement and distribution of controlled and validated personal protective equipment is the key to providing quality care while guaranteeing health care worker safety.

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Evaluation of the Panbio™ rapid antigen test for COVID-19 diagnosis in symptomatic health care workers.

10.1101/2021.06.21.21259234 ◽

2021 ◽

Author(s):

Marjan J. Bruins ◽

Claudy Oliveira dos Santos ◽

Marjan Spoelman-Lunsche ◽

Marieke I. van den Bos-Kromhout ◽

Sylvia B. Debast

Keyword(s):

Health Care ◽

Health Care Workers ◽

False Negative ◽

Rapid Test ◽

High Sensitivity ◽

High Tech ◽

Antigen Test ◽

Duration Of Symptoms ◽

Recent Onset ◽

Care Workers

If a health care workers (HCW) experiences COVID-19 associated symptoms, SARS-CoV-2 testing must be performed as soon as possible, to prevent transmission of the virus and to guarantee continuity of care. The gold standard for the detection of SARS-CoV-2, RT-PCR, has a high sensitivity but usually takes 6-8 hours. Lateral flow antigen assays take only 15-30 minutes and do not need any high tech equipment. In a prospective study of our hospital's HCWs, we evaluated the sensitivity of the Panbio™ COVID-19 Ag Rapid Test (Abbott) against the molecular test Aptima™ SARS-CoV-2 Assay (Hologic) which uses Transcription Mediated Amplification (TMA). TMA positive samples were further subjected to a quantitative real-time SARS-CoV-2 PCR to obtain Ct values as an indication of the viral load. Of 1101 HCWs included in the study between November 2020 and February 2021, 84 (7.6%) were TMA positive, of which 48 (57.1%) were antigen test positive. Most false negative antigen test results occurred if the duration of symptoms had been ≤1 day or ≥7 days. Sensitivities for symptom onset of ≤1, 2 or 3 days were 47.1%, 63.0% and 66.7% respectively. The Panbio™ rapid test is fast and easy to perform, but is not a suitable SARS-CoV-2 test to confirm or exclude COVID-19 in HCWs with a very recent onset of symptoms.

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AB0701 ANTIBODY RAPID TEST POSITIVE HEALTH CARE WORKERS AT A GERMAN UNIVERSITY HOSPITAL: FIRST WAVE CHARACTERISTICS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.3780 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 1383.1-1383

Author(s):

M. Beck ◽

A. Nieters ◽

M. Rizzi ◽

U. Salzer ◽

J. Thiel ◽

...

Keyword(s):

Health Care ◽

Everyday Life ◽

Health Care Workers ◽

Preventive Measures ◽

Rapid Test ◽

University Hospital ◽

Igm Antibodies ◽

Care Workers ◽

Exposure Prevention ◽

German Cities

Background:Freiburg was among the most heavily affected German cities during the first wave of Sars-Cov-2 infections in spring 2020. Consequently, the University Medical Center Freiburg was one of the first hospitals in Germany to treat Covid19 patients.Objectives:To assess the proportion and characteristics of health care workers (HCW) that have been infected during that first wave SARS-CoV-2 serum IgG and IgM antibodies were measured.Methods:HCW (n=902, mean age: 40.7 years) participated in this study, and filled out an epidemiological questionnaire. Serum samples were analysed for SARS-Cov-2 IgG/IgM antibodies via rapid diagnostic test (RT) and via ELISA. Statistical analyses were performed using STATA 14.2. An exposure prevention score was developed to quantify the adherence to preventive measures in everyday life.Results:902 HCW were tested by RT, and 499 by ELISA. In total, 11.5% of recruited HCW were antibody-positive in the RT, 12.2% in the ELISA. 87.5% of RT positives, 98% of ELISA-positives reported symptoms, compared to 74.6% and 78% of negatives, respectively. Symptoms such as cough (57%/46%), loss of smell and taste (34%/5.2%), fatigue (68%/45%), fever (48%/24%), body aches (45%/22%), and headaches (58%/46%) were reported by significantly more RT positives compared to negatives. The respective differences were even more pronounced (p<0.001) among ELISA-positives compared to negatives with >50% of those positive reported impaired smell or taste compared to less than 7% among the group of ELISA-negatives (p<0.00001).In logistic regression models, shift work and belonging to the lowest quartile of the exposure prevention score were significantly associated with seropositivity in both tests. Exposure towards children was inversely associated with seropositivity, however, in the finally adjusted model only significant for those that were RT-positive, but not ELISA-positive, reflecting the lower specificity of the former.Conclusion:The endemic infection rate in HCW was high. HCW adhering to preventive measures in everyday life had lower infection rates.Disclosure of Interests:Manuel Beck: None declared, Alexandra Nieters: None declared, Marta Rizzi: None declared, Ulrich Salzer: None declared, Jens Thiel Speakers bureau: BMS, Nils Venhoff Speakers bureau: Novartis, Nicole Peter: None declared, Hermann Eibel: None declared, Reinhard Voll Speakers bureau: Novartis, Grant/research support from: BMS, Pfizer, Novartis, Stephanie Finzel Speakers bureau: Novartis

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SARS-CoV-2 exposure, symptoms and seroprevalence in health care workers

10.1101/2020.06.22.20137646 ◽

2020 ◽

Cited By ~ 4

Author(s):

Ann-Sofie Rudberg ◽

Sebastian Havervall ◽

Anna Månberg ◽

August Jernbom Falk ◽

Katherina Aguilera ◽

...

Keyword(s):

Health Care ◽

Occupational Exposure ◽

Occupational Health ◽

Health Risk ◽

Health Care Workers ◽

Acute Care Hospital ◽

Worker Safety ◽

Care Hospital ◽

Cross Sectional ◽

Care Workers

AbstractBackgroundSARS-CoV-2 may pose an occupational health risk to health care workers, but the prevalence of infections in this population is unknown. We examined the seroprevalence of SARS-CoV-2 antibodies among health care workers at a large acute care hospital in Stockholm, Sweden. We determined correlations between seroprevalence, self-reported symptoms and occupational exposure to SARS-CoV-2.Methods and findingsAll employees at Danderyd Hospital (n=4375) were invited to participate in a cross-sectional study. 2149 employees from all hospital departments were enrolled in the study between April 14th and May 8th 2020. Study participants completed a questionnaire consisting of symptoms compatible with SARS-CoV-2 infection since January 2020 and occupational exposure to patients infected with SARS-CoV-2. IgG antibodies against SARS-CoV-2 were analyzed using a multiplex assay evaluated to have 99.4% sensitivity and 99.1% specificity. The over-all seroprevalence among 2149 participants was 19.1% (n=410). There was no difference in age or sex between seropositive and seronegative participants. The symptoms with the strongest correlation to seroprevalence were anosmia and ageusia, with odds ratios of 28.4 (p=2.02*10^-120) and 19.2 (p=1.67*10^-99) respectively. Seroprevalence was strongly associated with patient-related work (OR 2.9, p=4.24*10^-8), covid-19 patient contact (OR 1.43, p=0.003), and occupation as assisting nurse (OR 3.67, p=2.16*10^-9).ConclusionThese results demonstrate that anosmia and ageusia should be included in screening guidance and in the recommendations of self-isolation to reduce further spread of SARS-CoV-2. The results furthermore imply an occupational health risk for SARS-CoV-2 infection among hospital workers. Continued measures are warranted to assure healthcare worker safety and reduce transmission from health care settings to the community during the covid-19 outbreak.

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