Secure Healthcare Workers’ Health and Safety: Active Surveillance, Early Detection and Outbreak Management During COVID-19 Epidemic in Taiwan

2020 ◽  
Author(s):  
Huang Chi Chen ◽  
Mei Hsing Chen ◽  
ChunWei Shen ◽  
Meng Hsuan Hsieh ◽  
Lin Kun Wu ◽  
...  
2020 ◽  
Vol 41 (7) ◽  
pp. 765-771 ◽  
Author(s):  
Liang En Wee ◽  
Xiang Ying Jean Sim ◽  
Edwin Philip Conceicao ◽  
May Kyawt Aung ◽  
Jia Qing Goh ◽  
...  

AbstractObjective:Staff surveillance is crucial during the containment phase of a pandemic to help reduce potential healthcare-associated transmission and sustain good staff morale. During an outbreak of SARS-COV-2 with community transmission, our institution used an integrated strategy for early detection and containment of COVID-19 cases among healthcare workers (HCWs).Methods:Our strategy comprised 3 key components: (1) enforcing reporting of HCWs with acute respiratory illness (ARI) to our institution’s staff clinic for monitoring; (2) conducting ongoing syndromic surveillance to obtain early warning of potential clusters of COVID-19; and (3) outbreak investigation and management.Results:Over a 16-week surveillance period, we detected 14 cases of COVID-19 among HCWs with ARI symptoms. Two of the cases were linked epidemiologically and thus constituted a COVID-19 cluster with intrahospital HCW–HCW transmission; we also detected 1 family cluster and 2 clusters among HCWs who shared accommodation. No transmission to HCWs or patients was detected after containment measures were instituted. Early detection minimized the number of HCWs requiring quarantine, hence preserving continuity of service during an ongoing pandemic.Conclusions:An integrated surveillance strategy, outbreak management, and encouraging individual responsibility were successful in early detection of clusters of COVID-19 among HCWs. With ongoing local transmission, vigilance must be maintained for intrahospital spread in nonclinical areas where social mingling of HCWs occurs. Because most individuals with COVID-19 have mild symptoms, addressing presenteeism is crucial to minimize potential staff and patient exposure.


2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Kwuntida Uthaisar Kotepui ◽  
Manas Kotepui ◽  
Chuchard Punsawad

Malaria is a potential medical emergency and should be treated immediately because delays in diagnosis and treatment are the leading causes of death in many countries. This study aimed to assess the knowledge, attitude, and practice related to malaria diagnosis for early detection among healthcare workers in the laboratories of hospitals in Thailand. The design of the study was a descriptive cross-sectional study carried out between January 2016 and March 2017 at 11 hospitals in Thailand. The interviewees included any scientists who were currently working in a medical laboratory. Mean scores for knowledge, attitude, and practice for each healthcare group were calculated and compared between groups. Data analysis was performed using the SPSS version 11.5 software package (SPSS Inc., Chicago, IL, USA). Among a total of 118 healthcare workers, most of the healthcare workers had fair to good knowledge, attitude, and practice related to malaria detection. Among the various positions of healthcare workers, medical technologists possessed a greater knowledge on malaria detection than medical technician assistants or laboratory assistants (X2 = 9.822, d.f. = 2, and P value=0.007). This study infers that knowledge, attitude, and practice related to malaria detection among healthcare workers in laboratories were adequate. However, some points of knowledge and practice must be updated. There is a very urgent need to update knowledge on malaria, especially about the number of Plasmodium species causing relapse in malaria patients. In addition, there is an urgent need to update the practice related to malaria detection, especially about the staining process for early detection of malaria.


BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e017476 ◽  
Author(s):  
Bandar Abdulmohsen Al Knawy ◽  
Hanan M F Al-Kadri ◽  
Mahmoud Elbarbary ◽  
Yaseen Arabi ◽  
Hanan H Balkhy ◽  
...  

ObjectivesThis study examines perceptions of the operational and organisational management of a major outbreak of Middle East Respiratory Syndrome (MERS) caused by a novel coronavirus (MERS-CoV) in the Kingdom of Saudi Arabia (KSA). Perspectives were sought from key decision-makers and clinical staff about the factors perceived to promote and inhibit effective and rapid control of the outbreak.SettingA large teaching tertiary healthcare centre in KSA; the outbreak lasted 6 weeks from June 2015.ParticipantsData were collected via individual and focus group interviews with 28 key informant participants (9 management decision-makers and 19 frontline healthcare workers).DesignWe used qualitative methods of process evaluation to examine perceptions of the outbreak and the factors contributing to, or detracting from successful management. Data were analysed using qualitative thematic content analysis.ResultsFive themes and 15 subthemes were found. The themes were related to: (1) the high stress of the outbreak, (2) factors perceived to contribute to outbreak occurrence, (3) factors perceived to contribute to success of outbreak control, (4) factors inhibiting outbreak control and (5) long-term institutional gains in response to the outbreak management.ConclusionManagement of the MERS-CoV outbreak at King Abdulaziz Medical City-Riyadh was widely recognised by staff as a serious outbreak of local and national significance. While the outbreak was controlled successfully in 6 weeks, progress in management was inhibited by a lack of institutional readiness to implement infection control (IC) measures and reduce patient flow, low staff morale and high anxiety. Effective management was promoted by greater involvement of all staff in sharing learning and knowledge of the outbreak, developing trust and teamwork and harnessing collective leadership. Future major IC crises could be improved via measures to strengthen these areas, better coordination of media management and proactive staff counselling and support.


2019 ◽  
Vol 8 (2) ◽  
pp. 121-128 ◽  
Author(s):  
Barbara J. Polivka ◽  
Sarah Anderson ◽  
Steve A. Lavender ◽  
Carolyn M. Sommerich ◽  
Donald L. Stredney ◽  
...  

2007 ◽  
Vol 28 (4) ◽  
pp. 423-429 ◽  
Author(s):  
Pei-Chun Chan ◽  
Li-Min Huang ◽  
Hui-Chi Lin ◽  
Luan-Yin Chang ◽  
Mei-Ling Chen ◽  
...  

Objective.To investigate the potential reservoir and mode of transmission of pandrug-resistant (PDR)Acinetobacter baumanniiin a 7-day-old neonate who developed PDRA. baumanniibacteremia that was presumed to be the iceberg of a potential outbreak.Design.Outbreak investigation based on a program of prospective hospital-wide surveillance for nosocomial infection.Setting.A 24-bed neonatal intensive care unit in a 2,200-bed major teaching hospital in Taiwan that provides care for critically ill neonates born in this hospital and those transferred from other hospitals.Interventions.Samples from 33 healthcare workers' hands and 40 samples from the environment were cultured. Surveillance cultures of anal swab specimens and sputum samples were performed for neonates on admission to the neonatal intensive care unit and every 2 weeks until discharge. The PDRA. baumanniiisolates, defined as isolates resistant to all currently available systemic antimicrobials except polymyxin B, were analyzed by pulsed-field gel electrophoresis. Control measures consisted of implementing contact isolation, reinforcing hand hygiene adherence, cohorting of nurses, and environmental cleaning.Results.One culture of an environmental sample and no cultures of samples from healthcare workers' hands grew PDRA. baumannii. The positive culture result involved a sample obtained from a ventilation tube used by the index patient. During the following 2 months, active surveillance identified PDRA. baumanniiin 8 additional neonates, and isolates from 7 had the same electrokaryotype. Of the 9 neonates colonized or infected with PDRA. baumannii, 1 died from an unrelated condition. Reinforcement of infection control measures resulted in 100% adherence to proper hand hygiene protocol. The outbreak was stopped without compromising patient care.Conclusions.In the absence of environmental contamination, transient hand carriage by personnel who cared for neonates colonized or infected with PDRA. baumanniiwas suspected to be the mode of transmission. Vigilance, prompt intervention and strict adherence to hand hygiene protocol were the key factors that led to the successful control of this outbreak. Active surveillance appears to be an effective measure to identify potential transmitters and reservoirs of PDRA. baumannii.


2010 ◽  
Vol 31 (8) ◽  
pp. 786-795 ◽  
Author(s):  
Jesus Jesús Rodríguez-Baño ◽  
Lola García ◽  
Encarnación Ramírez ◽  
Carmen Lupión ◽  
Miguel A. Muniain ◽  
...  

Objective.To evaluate the long-term impact of successive interventions on rates of methicillin-resistantStaphylococcus aureus(MRSA) colonization or infection and MRSA bacteremia in an endemic hospital-wide situation.Design.Quasi-experimental, interrupted time-series analysis. The impact of the interventions was analyzed by use of segmented regression. Representative MRSA isolates were typed by use of pulsed-field gel electrophoresis.Setting.A 950-bed teaching hospital in Seville, Spain.Patients.All patients admitted to the hospital during the period from 1995 through 2008.Methods.Three successive interventions were studied: (1) contact precautions, with no active surveillance for MRSA; (2) targeted active surveillance for MRSA in patients and healthcare workers in specific wards, prioritized according to clinical epidemiology data; and (3) targeted active surveillance for MRSA in patients admitted from other medical centers.Results.Neither the preintervention rate of MRSA colonization or infection (0.56 cases per 1,000 patient-days [95% confidence interval {CI}, 0.49-0.62 cases per 1,000 patient-days]) nor the slope for the rate of MRSA colonization or infection changed significantly after the first intervention. The rate decreased significantly to 0.28 cases per 1,000 patient-days (95% CI, 0.17-0.40 cases per 1,000 patient-days) after the second intervention and to 0.07 cases per 1,000 patient-days (95% CI, 0.06-0.08 cases per 1,000 patient-days) after the third intervention, and the rate remained at a similar level for 8 years. The MRSA bacteremia rate decreased by 80%, whereas the rate of bacteremia due to methicillin-susceptibleS. aureusdid not change. Eighty-three percent of the MRSA isolates identified were clonally related. All MRSA isolates obtained from healthcare workers were clonally related to those recovered from patients who were in their care.Conclusion.Our data indicate that long-term control of endemic MRSA is feasible in tertiary care centers. The use of targeted active surveillance for MRSA in patients and healthcare workers in specific wards (identified by means of analysis of clinical epidemiology data) and the use of decolonization were key to the success of the program.


BMJ Open ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. e058048
Author(s):  
Philip Apraku Tawiah ◽  
Alberta Baffour-Awuah ◽  
Emmanuel Appiah-Brempong ◽  
Evans Afriyie-Gyawu

IntroductionThe formation, modification and implementation of occupational health and safety policy for the Ghana healthcare industry hinge on data and reviews on occupational exposures. However, there is no synthesised review to speak to the issues of these occupational exposures. A scoping review on occupational exposures among the health workforce in Ghana will provide a broad overview of exposures, and can guide and assist in making decisions on occupational health issues relating to healthcare workers.Methods and analysisArksey and O’Malley’s scoping review methodology framework will guide the conduct of this scoping review. Primary research studies, government documents and other information on occupational exposures among healthcare workers published in the English language will be retrieved from databases including PubMed, CINAHL, Embase, MEDLINE, Scopus, PsycINFO and Google scholar. A systematic search strategy will be employed to identify articles from 1 January 2010 until 30 November 2021. Also, grey literature sources in Ghana including government and tertiary institutions websites will be searched. A reference list of key studies and other available non-electronic materials will also be screened to identify relevant studies for inclusion. The review will consider studies that address prevalence, knowledge and predisposing factors of occupational exposures along with the use of occupational hazards control/preventive measures. After removal of duplicates, and title and abstract screening, relevant articles will be subjected to full-text analysis. The screening processes will be conducted independently by two reviewers. Data will then be extracted and presented in tabular form with a narrative to aid easy comprehension.Ethics and disseminationThis scoping review does not require ethical approval. The findings will be disseminated through publications, conference presentations and stakeholder meetings.


Sign in / Sign up

Export Citation Format

Share Document