scholarly journals Title page Title Perspectives on COVID-19 testing policies and practices: a qualitative study with scientific advisors and NHS health care workers in England

2021 ◽  
Author(s):  
Anne-Marie Martindale ◽  
Caitlin Pilbeam ◽  
Hayley Mableson ◽  
Sarah Tonkin-Crine ◽  
Paul Atkinson ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Local Level ◽  
Scale Up ◽  
Normalisation Process Theory ◽  
Framework Analysis ◽  
Implementation Framework ◽  
Testing Strategies ◽  
Care Workers ◽  
National Testing

Abstract Background As COVID-19 death rates have risen and health-care systems have experienced increased demand, national testing strategies have come under scrutiny. Utilising qualitative interview data from a larger COVID-19 study, this paper provides insights into influences on and the enactment of national COVID-19 testing strategies for health care workers (HCWs) in English NHS settings during wave one of the COVID-19 pandemic (March-August 2020). We aim to inform COVID-19 learning and future pandemic diagnostic preparedness.Methods A remote qualitative, semi-structured longitudinal interview method was employed with a purposive snowball sample of senior scientific advisors to the UK Government on COVID-19, and HCWs employed in NHS primary and secondary health care settings in England. 24 interviews from 13 participants were selected from the larger project dataset. Framework analysis was informed by the non-adoption, abandonment, scale-up, spread, and sustainability of patient-facing health and care technologies implementation framework (NASSS) and by normalisation process theory (NPT).Results Our account highlights tensions between the communication and implementation of national testing developments; scientific advisor and HCW perceptions about infectiousness; and uncertainties about the responsibility for testing and its implications at the local level.Conclusions Consideration must be given to the implications of mass NHS staff testing, including the accuracy of information communicated to HCWs; how HCWs interpret, manage, and act on testing guidance; and the influence these have on health care organisations and services.

scholarly journals Perspectives on COVID-19 testing policies and practices: a qualitative study with scientific advisors and NHS health care workers in England

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anne-Marie Martindale ◽  
Caitlin Pilbeam ◽  
Hayley Mableson ◽  
Sarah Tonkin-Crine ◽  
Paul Atkinson ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Local Level ◽  
Normalisation Process Theory ◽  
Implementation Framework ◽  
Testing Strategies ◽  
Care Workers ◽  
National Testing ◽  
Testing Policies ◽  
Policies And Practices

Abstract Background As COVID-19 death rates have risen and health-care systems have experienced increased demand, national testing strategies have come under scrutiny. Utilising qualitative interview data from a larger COVID-19 study, this paper provides insights into influences on and the enactment of national COVID-19 testing strategies for health care workers (HCWs) in English NHS settings during wave one of the COVID-19 pandemic (March–August 2020). Through the findings we aim to inform learning about COVID-19 testing policies and practices; and to inform future pandemic diagnostic preparedness. Methods A remote qualitative, semi-structured longitudinal interview method was employed with a purposive snowball sample of senior scientific advisors to the UK Government on COVID-19, and HCWs employed in NHS primary and secondary health care settings in England. Twenty-four interviews from 13 participants were selected from the larger project dataset using a key term search, as not all of the transcripts contained references to testing. Framework analysis was informed by the non-adoption, abandonment, scale-up, spread, and sustainability of patient-facing health and care technologies implementation framework (NASSS) and by normalisation process theory (NPT). Results Our account highlights tensions between the communication and implementation of national testing developments; scientific advisor and HCW perceptions about infectiousness; and uncertainties about the responsibility for testing and its implications at the local level. Conclusions Consideration must be given to the implications of mass NHS staff testing, including the accuracy of information communicated to HCWs; how HCWs interpret, manage, and act on testing guidance; and the influence these have on health care organisations and services.

scholarly journals “The right time is just after birth”: Acceptability of point-of-care birth testing in Eswatini: qualitative results from infant caregivers, health care workers, and policymakers

2020 ◽  
Author(s):  
Emma Sacks ◽  
Philisiwe Khumalo ◽  
Bhekisisa Tsabedze ◽  
William Montgomery ◽  
Nobuhle Mthethwa ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Point Of Care ◽  
Scale Up ◽  
Testing Machine ◽  
Strong Support ◽  
Return Of Results ◽  
Care Workers ◽  
Birth Testing ◽  
The Right

Abstract Background: Testing for HIV at birth has the potential to identify infants infected in utero , and allows for the possibility of beginning treatment immediately after birth; point of care (POC) testing allows rapid return of results and faster initiation on treatment for positive infants. Eswatini piloted birth testing in three public maternities for over two years. Methods: In order to assess the acceptability of POC birth testing in the pilot sites in Eswatini, interviews were held with caregivers of HIV-exposed infants who were offered birth testing (N=28), health care workers (N=14), and policymakers (N=10). Participants were purposively sampled. Interviews were held in English or SiSwati, and transcribed in English. Transcripts were coded by line, and content analysis and constant comparison were used to identify key themes for each respondent type. Results: Responses were categorized into: knowledge, experience, opinions, barriers and challenges, facilitators, and suggestions to improve POC birth testing. Preliminary findings reveal that point of care birth testing has been very well received but challenges were raised. Most caregivers appreciated testing the newborns at birth and getting results quickly, since it reduced anxiety of waiting for several weeks. However, having a favorable experience with testing was linked to having supportive and informed family members and receiving a negative result. Caregivers did not fully understand the need for blood draws as opposed to tests with saliva, and expressed the fears of seeing their newborns in pain. They were specifically grateful for supportive nursing staff who respected their confidentiality. Health care workers expressed strong support for the program but commented on the high demand for testing, increased workload, difficulty with errors in the testing machine itself, and struggles to implement the program without sufficient staffing, especially on evenings and weekends when phlebotomists were not available. Policymakers noted that there have been challenges within the program of losing mothers to follow up after they leave hospital, and recommended stronger linkages to community groups. Conclusions: There is strong support for scale-up of POC birth testing, but countries should consider ways to optimize staffing and manage demand.

scholarly journals Acceptability, feasibility, and likelihood of stakeholders implementing the novel BPaL regimen to treat extensively drug-resistant tuberculosis patients

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
S. E. J. van de Berg ◽  
P. T. Pelzer ◽  
A. J. van der Land ◽  
E. Abdrakhmanova ◽  
A. Muhammad Ozi ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Financial Burden ◽  
Safety Monitoring ◽  
Drug Resistant ◽  
Framework Analysis ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Extensively Drug Resistant ◽  
Care Workers

Abstract Background BPaL, a 6 month oral regimen composed of bedaquiline, pretomanid, and linezolid for treating extensively drug-resistant tuberculosis (XDR-TB) is a potential alternative for at least 20 months of individualized treatment regimens (ITR). The ITR has low tolerability, treatment adherence, and success rates, and hence to limit patient burden, loss to follow-up and the emergence of resistance it is essential to implement new DR-TB regimens. The objective of this study was to assess the acceptability, feasibility, and likelihood of implementing BPaL in Indonesia, Kyrgyzstan, and Nigeria. Methods We conducted a concurrent mixed-methods study among a cross-section of health care workers, programmatic and laboratory stakeholders between May 2018 and May 2019. We conducted semi-structured interviews and focus group discussions to assess perceptions on acceptability and feasibility of implementing BPaL. We determined the proportions of a recoded 3-point Likert scale (acceptable; neutral; unacceptable), as well as the overall likelihood of implementing BPaL (likely; neutral; unlikely) that participants graded per regimen, pre-defined aspect and country. We analysed the qualitative results using a deductive framework analysis. Results In total 188 stakeholders participated in this study: 63 from Kyrgyzstan, 51 from Indonesia, and 74 from Nigeria The majority were health care workers (110). Overall, 88% (146/166) of the stakeholders would likely implement BPaL once available. Overall acceptability for BPaL was high, especially patient friendliness was often rated as acceptable (93%, 124/133). In contrast, patient friendliness of the ITR was rated as acceptable by 45%. Stakeholders appreciated that BPaL would reduce workload and financial burden on the health care system. However, several stakeholders expressed concerns regarding BPaL safety (monitoring), long-term efficacy, and national regulatory requirements regarding introduction of the regimen. Stakeholders stressed the importance of addressing current health systems constraints as well, especially in treatment and safety monitoring systems. Conclusions Acceptability and feasibility of the BPaL regimen is high among TB stakeholders in Indonesia, Kyrgyzstan, and Nigeria. The majority is willing to start using BPaL as the standard of care for eligible patients despite country-specific health system constraints.

scholarly journals “The right time is just after birth”: Acceptability of point-of-care birth testing in Eswatini: qualitative results from infant caregivers, health care workers, and policymakers

2020 ◽  
Author(s):  
Emma Sacks ◽  
Philisiwe Khumalo ◽  
Bhekisisa Tsabedze ◽  
William Montgomery ◽  
Nobuhle Mthethwa ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Point Of Care ◽  
Scale Up ◽  
Testing Machine ◽  
Strong Support ◽  
Return Of Results ◽  
Care Workers ◽  
Birth Testing ◽  
The Right

Abstract Background: Testing for HIV at birth has the potential to identify infants infected in utero, and allows for the possibility of beginning treatment immediately after birth; point of care (POC) testing allows rapid return of results and faster initiation on treatment for positive infants. Eswatini piloted birth testing in three public maternities for over two years. Methods: In order to assess the acceptability of POC birth testing in the pilot sites in Eswatini, interviews were held with caregivers of HIV-exposed infants who were offered birth testing (N=28), health care workers (N=14), and policymakers (N=10). Participants were purposively sampled. Interviews were held in English or SiSwati, and transcribed in English. Transcripts were coded by line, and content analysis and constant comparison were used to identify key themes for each respondent type. Results: Responses were categorized into: knowledge, experience, opinions, barriers and challenges, facilitators, and suggestions to improve POC birth testing. Preliminary findings reveal that point of care birth testing has been very well received but challenges were raised. Most caregivers appreciated testing the newborns at birth and getting results quickly, since it reduced anxiety of waiting for several weeks. However, having a favorable experience with testing was linked to having supportive and informed family members and receiving a negative result. Caregivers did not fully understand the need for blood draws as opposed to tests with saliva, and expressed the fears of seeing their newborns in pain. They were specifically grateful for supportive nursing staff who respected their confidentiality. Health care workers expressed strong support for the program but commented on the high demand for testing, increased workload, difficulty with errors in the testing machine itself, and struggles to implement the program without sufficient staffing, especially on evenings and weekends when phlebotomists were not available. Policymakers noted that there have been challenges within the program of losing mothers to follow up after they leave hospital, and recommended stronger linkages to community groups. Conclusions: There is strong support for scale-up of POC birth testing, but countries should consider ways to optimize staffing and manage demand.

scholarly journals Quadmester-wise comparison of disease transmission dynamics of COVID-19 among health care workers in Kannur district, Kerala

2021 ◽  
Vol 8 (5) ◽  
pp. 2481
Author(s):  
Ameena Subair Raheela ◽  
Sajish Chandran ◽  
Deepak Rajan ◽  
Preetha Muduvana
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Disease Transmission ◽  
Local Level ◽  
Control Measures ◽  
Transmission Dynamics ◽  
Work Place ◽  
Cross Sectional ◽  
Indirect Contact ◽  
Care Workers

Background: Health-care workers (HCWs) may get infected by direct or indirect contact with infected patients or other HCWs or from the community as well, depending on the phase through which pandemic progresses. Knowledge about the disease transmission dynamics as the pandemic advances is a need so that appropriate monitoring, prevention and control measures for HCWs can be implemented at local level. The main objective of this study was quadmester-wise comparison of disease transmission dynamics of COVID-19 among HCWs in Kannur district.Methods: A cross-sectional study was carried out among HCWs reported positive for SARS-CoV-2 in Kannur district, Kerala. COVID-19 positive HCWs reported in the district were consolidated and contacted over phone and details were collected using a semi-structured questionnaire. Data were entered into microsoft excel and analysed using statistical package for social sciences (SPSS) trial version. Chi-square test was used to compare differences observed in the two groups and binary logistic regression was done to pick out the significant predictors of variability in disease transmission among the two groups.Results: Total respondents in the first and second quadmester were 243 and 1665, respectively. Factors like gender, clinical features, source of infection, family as source and type of duty taken were found to be statistically significant for the disease transmission dynamics among HCWs.Conclusions: As the pandemic advances, irrespective of the type of work place, self-reporting and regular testing of HCWs will help to check HCWs from getting infected and spreading the disease.

scholarly journals Optimal strategies to screen health care workers for COVID-19 in the US: a cost-effectiveness analysis

2022 ◽  
Vol 20 (1) ◽  
Author(s):  
Sigal Maya ◽  
Guntas Padda ◽  
Victoria Close ◽  
Trevor Wilson ◽  
Fareeda Ahmed ◽  
...  
Keyword(s):  
Health Care ◽  
Cost Effectiveness ◽  
Health Care Workers ◽  
Cost Effective ◽  
Health Care Settings ◽  
Testing Strategies ◽  
Effectiveness Analysis ◽  
Care Workers ◽  
Antigen Testing ◽  
Quality Adjusted Life

Abstract Background Transmission of SARS-CoV-2 in health care facilities poses a challenge against pandemic control. Health care workers (HCWs) have frequent and high-risk interactions with COVID-19 patients. We undertook a cost-effectiveness analysis to determine optimal testing strategies for screening HCWs to inform strategic decision-making in health care settings. Methods We modeled the number of new infections, quality-adjusted life years lost, and net costs related to six testing strategies including no test. We applied our model to four strata of HCWs, defined by the presence and timing of symptoms. We conducted sensitivity analyses to account for uncertainty in inputs. Results When screening recently symptomatic HCWs, conducting only a PCR test is preferable; it saves costs and improves health outcomes in the first week post-symptom onset, and costs $83,000 per quality-adjusted life year gained in the second week post-symptom onset. When screening HCWs in the late clinical disease stage, none of the testing approaches is cost-effective and thus no testing is preferable, yielding $11 and 0.003 new infections per 10 HCWs. For screening asymptomatic HCWs, antigen testing is preferable to PCR testing due to its lower cost. Conclusions Both PCR and antigen testing are beneficial strategies to identify infected HCWs and reduce transmission of SARS-CoV-2 in health care settings. IgG tests’ value depends on test timing and immunity characteristics, however it is not cost-effective in a low prevalence setting. As the context of the pandemic evolves, our study provides insight to health-care decision makers to keep the health care workforce safe and transmissions low.

scholarly journals The First Hundred Days of Novel Corona-virus Disease 2019 in Ethiopia, 13 March to 21 June 2020: Retrospective Analysis

2020 ◽  
Author(s):  
Shambel Habebe Watare ◽  
Zewdu Assefa Edea ◽  
Haftom Taame Desta ◽  
Fantu Lombamo ◽  
Negussie Yohannes ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Addis Ababa ◽  
Scale Up ◽  
Control Measures ◽  
Contact Tracing ◽  
National Database ◽  
Infection Prevention And Control ◽  
Care Workers ◽  
Epidemiological Characteristics

Abstract BackgroundThe Novel Coronavirus Disease 2019 (COVID-19) pandemic was originated from Wuhan city, China and spread to almost all countries and territories in the world. Ethiopia reported its first COVID-19 confirmed case on 13 March, 2020. This study aims to show the epidemiological characteristics of the pandemic in Ethiopia in the first hundred days, which would help to guide the ongoing national response efforts to control and prevent the spread of the disease through generating scientific evidence.MethodWe conducted secondary data analysis of COVID-19 data extracted from a national database at Ethiopian Public Health Institute from 13 March to 21 June, 2020. We anonymized personal information for privacy protection. Data was cleaned and descriptive analyses was employed. We used Arc GIS to illustrate the geographical distribution of COVID-19 cases.ResultsOf the 216,328 examined individuals, 4,534 (2.1%) tested positive for COVID-19 of which 74(CFR: 1.6%) have died. People aged between 20–49 years attributed for 76.3% of the total cases. Majority, 2,851 (62.9%) of the cases were male, 3,222 (71.3%) reported from Addis Ababa, 982 (21.7%) of the cases were imported, 413(9.1%) had contact with confirmed cases, 3,139 (69.2%) had no travel history nor contact with confirmed case, and 4,180 (92.2%) of the cases reported were asymptomatic. Health Care Workers contributed for 3.7% of the total cases reported.ConclusionThe magnitude and distribution of COVID-19 cases and deaths and Health Care Workers infection has increased throughout the country over-time. Due emphasis needs to be given by the government, all stakeholders, and partners to scale-up and expand laboratory diagnosis capacities, strengthen surveillance and contact tracing, implement proper Infection Prevention and Control measures, improve case management services and the community should strictly follow social distancing measures. There should be an appropriate health care workers risk factors assessment and intervention to adequately protect the health care workers exposure and infection. Further study shall be conducted to describe the knowledge gaps on the asymptomatic transmission of the virus.

scholarly journals Optimal strategies to screen health care workers for COVID-19 in the US: a cost-effectiveness analysis

2021 ◽  
Author(s):  
Sigal Maya ◽  
Guntas Padda ◽  
Victoria Close ◽  
Trevor Wilson ◽  
Fareeda Ahmed ◽  
...  
Keyword(s):  
Health Care ◽  
Cost Effectiveness ◽  
Health Care Workers ◽  
Cost Effective ◽  
Health Care Settings ◽  
Testing Strategies ◽  
Effectiveness Analysis ◽  
Care Workers ◽  
Antigen Testing ◽  
Quality Adjusted Life

Abstract Background: Transmission of SARS-CoV-2 in health care facilities poses a challenge against pandemic control. Health care workers (HCWs) have frequent and high-risk interactions with COVID-19 patients. We undertook a cost-effectiveness analysis to determine optimal testing strategies for screening HCWs to inform strategic decision-making in health care settings. Methods: We modeled the number of new infections, quality-adjusted life years lost, and net costs related to six testing strategies including no tests. We applied our model to four strata of HCWs, defined by the presence and timing of symptoms. We conducted sensitivity analyses to account for uncertainty in inputs. Results: When screening recently symptomatic HCWs, conducting only a PCR test is preferable; it saves costs and improves health outcomes in the first week post-symptom onset, and costs $83,000 per quality-adjusted life year gained in the second week post-symptom onset. When screening HCWs in the late clinical disease stage, none of the testing approaches is cost-effective and thus no testing is preferable, yielding $11 and 0.003 new infections per 10 HCWs. For screening asymptomatic HCWs, antigen testing is preferable to PCR testing due to its lower cost. Conclusions: Both PCR and antigen testing are beneficial strategies to identify infected HCWs and reduce transmission of SARS-CoV-2 in health care settings. IgG testing clinical value depends on test timing and immunity characteristics, however is not cost-effective in a low prevalence setting. As the context of the pandemic evolves, our study provides insight to health-care decision makers to keep the health care workforce safe and transmissions low.

Organizational Factors and Health Care Workers' Physical Safety

2013 ◽  
Author(s):  
Jane Lipscomb ◽  
Jeanne Geiger-Brown ◽  
Katherine McPhaul ◽  
Karen Calabro
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Organizational Factors ◽  
Care Workers
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