scholarly journals Critical Care Workers Have Lower Seroprevalence of SARS-CoV-2 IgG Compared with Non-patient Facing Staff in First Wave of COVID19

2021 ◽  
Vol 7 (3) ◽  
pp. 199-210
Author(s):  
Helen E. Baxendale ◽  
David Wells ◽  
Jessica Gronlund ◽  
Angalee Nadesalingham ◽  
Mina Paloniemi ◽  
...  
Keyword(s):  
Critical Care ◽  
Clinical Symptoms ◽  
Infection Frequency ◽  
Hospital Acquired Infection ◽  
Care Workers ◽  
Increased Risk ◽  
Symptom Severity Score ◽  
History Of ◽  
Viral Surveillance ◽  
Hospital Acquired

Abstract Introduction: In early 2020, at first surge of the coronavirus disease 2019 (COVID-19) pandemic, many health care workers (HCW) were re-deployed to critical care environments to support intensive care teams looking after patients with severe COVID-19. There was considerable anxiety of increased risk of COVID-19 for these staff. To determine whether critical care HCW were at increased risk of hospital acquired infection, we explored the relationship between workplace, patient facing role and evidence of immune exposure to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) within a quaternary hospital providing a regional critical care response. Routine viral surveillance was not available at this time. Methods: We screened over 500 HCW (25% of the total workforce) for history of clinical symptoms of possible COVID19, assigning a symptom severity score, and quantified SARS-CoV-2 serum antibodies as evidence of immune exposure to the virus. Results: Whilst 45% of the cohort reported symptoms that they consider may have represented COVID-19, 14% had evidence of immune exposure. Staffs in patient facing critical care roles were least likely to be seropositive (9%) and staff working in non-patient facing roles most likely to be seropositive (22%). Anosmia and fever were the most discriminating symptoms for seropositive status. Older males presented with more severe symptoms. Of the 12 staff screened positive by nasal swab (10 symptomatic), 3 showed no evidence of seroconversion in convalescence. Conclusions: Patient facing staff working in critical care do not appear to be at increased risk of hospital acquired infection however the risk of nosocomial infection from non-patient facing staff may be more significant than previous recognised. Most symptoms ascribed to possible COVID-19 were found to have no evidence of immune exposure however seroprevalence may underrepresent infection frequency. Older male staff were at the greatest risk of more severe symptoms.

Critical care of burns patients

2019 ◽  
pp. 109-116
Author(s):  
Francis Andrews
Keyword(s):  
Critical Care ◽  
Fluid Management ◽  
Lower Airway ◽  
Evidence Based ◽  
Collaborative Approach ◽  
Hospital Acquired Infection ◽  
Airway Injury ◽  
Increased Risk ◽  
Critical Care Management ◽  
Hospital Acquired

The critical care management of burns patients requires a multidisciplinary collaborative approach to optimise the chances of patient survival. Early oral endotracheal intubation is essential if there is evidence of airway injury or injury that will affect breathing capacity, with early bronchoscopic evaluation of the upper and lower airway. Mechanical ventilation should follow strategies for acute respiratory distress syndrome (ARDS) management and weaning from ventilation requires an evidence-based approach; patients may require a tracheostomy as part of a weaning process. Burns patients are at an increased risk of hospital-acquired infection, especially ventilator acquired pneumonia and vascular catheter infection which should be treated rapidly. Attention to balanced sedation and nutrition are required to optimize the care of these patients. Another particular risk is acute renal failure due to rhabdomyolysis and careful fluid management is required to try and prevent this serious complication.

scholarly journals Knowledge and Compliance Toward Standard Precaution Among Health Care Workers at Bahria International Hospital Lahore, Pakistan

2020 ◽  
Vol 7 (1) ◽  
pp. 17-20
Author(s):  
Humira Ather ◽  
Asaf Khan ◽  
Saima Shabnum
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Healthcare Workers ◽  
P Value ◽  
Hospital Acquired Infection ◽  
Standard Precaution ◽  
Care Workers ◽  
Knowledge And Practice ◽  
Control Infection ◽  
Hospital Acquired

Introduction: Standard precaution is a way to stop the spread of hospital acquired infection which may be in the form of blood, secretions, body waste, body fluids and mucous membrane that may contain contagious infectious agents. Healthcare workers are the persons who have the moral obligation to care for sick persons and improve their regaining health and attain excellent worth of treatment care. Therefore, health care providers should have proper knowledge and good practice to strictly adhere to standard precaution control infection. Aim: To determine the knowledge and compliance toward standard precaution among health care workers in Bahria international Hospital Lahore. Methodology: a descriptive cross sectional study design were used for this study with sample size of 180 participants which were randomly selected from the target population. Results: The association between knowledge and practice was assessed through chi square test with p value=0.05, after apply this test the p value found .000 which is significant association between knowledge and practice. Whereas regression test shows value of adjusted R² showing 60% (F=.141, p <.001) of variance caused by independent variable (knowledge) in dependent variable (practice). Hence, it is proved that there is a significant positive relationship between knowledge and practice. Conclusion: The current study concluded that adhering to standard precaution is very important for all health care workers to control hospital acquired infection. Study finding also show that majority of the healthcare workers have good knowledge regarding standard precautions but they have unsatisfactory compliance to prevent and control infection. Int. J. Soc. Sc. Manage. 7(1): 17-20

scholarly journals A History of Cerebrovascular Disease Is Independently Associated with Increased Morbidity and Mortality in Patients with COVID-19: A Cohort Study of 369,563 COVID-19 Cases in the USA

2021 ◽  
pp. 1-9
Author(s):  
Anna M. Nia ◽  
Visish M. Srinivasan ◽  
Miranda K. Hayworth ◽  
Rishi R. Lall ◽  
Peter Kan
Keyword(s):  
Critical Care ◽  
Cerebrovascular Disease ◽  
Morbidity And Mortality ◽  
Prior History ◽  
Care Services ◽  
Relative Risks ◽  
Previous Diagnosis ◽  
Increased Risk ◽  
The Usa ◽  
History Of

<b><i>Objectives:</i></b> We set out to evaluate the risk for severe coronavirus disease 2019 (COVID-19) infection and subsequent cerebrovascular disease (CVD) in the population with a prior diagnosis of CVD within the past 10 years. <b><i>Methods:</i></b> We utilized the TriNetX Analytics Network to query 369,563 CO­VID-19 cases up to December 30, 2020. We created 8 cohorts of patients with COVID-19 diagnosis based on a previous diagnosis of CVD. We measured the odds ratios, relative risks, risk differences for hospitalizations, ICU/critical care services, intubation, mortality, and CVD recurrence within 90 days of COVID-19 diagnosis, compared to a propensity-matched cohort with no prior history of CVD within 90 days of COVID-19 diagnosis. <b><i>Results:</i></b> 369,563 patients had a confirmed diagnosis of COVID-19 with a subset of 22,497 (6.09%) patients with a prior diagnosis of CVD within 10 years. All cohorts with a CVD diagnosis had an increased risk of hospitalization, critical care services, and mortality within 90 days of COVID-19 diagnosis. Additionally, the data demonstrate that any history of CVD is associated with significantly increased odds of subsequent CVD post-COVID-19 compared to a matched control. <b><i>Conclusions:</i></b> CVD, a known complication of CO­VID-19, is more frequent in patients with a prior history of CVD. Patients with any previous diagnosis of CVD are at higher risks of morbidity and mortality from COVID-19 infection. In patients admitted to the ED due to COVID-19 symptoms, these risk factors should be promptly identified as delayed or missed risk stratification and could lead to an ineffective and untimely diagnosis of subsequent CVD, which would lead to protracted hospitalization and poor prognosis.

scholarly journals Combination Therapy with Aminoglycoside in Bacteremiasdue to ESBL-Producing Enterobacteriaceae in ICU

Antibiotics ◽  
2020 ◽  
Vol 9 (11) ◽  
pp. 777
Author(s):  
Lucie Benetazzo ◽  
Pierre-Yves Delannoy ◽  
Marion Houard ◽  
Frederic Wallet ◽  
Fabien Lambiotte ◽  
...  
Keyword(s):  
Death Rate ◽  
Distress Syndrome ◽  
Bloodstream Infections ◽  
Observational Cohort Study ◽  
Icu Patients ◽  
Hospital Acquired Infection ◽  
History Of ◽  
Observational Cohort ◽  
Hospital Acquired ◽  
Retrospective Observational Cohort Study

Objectives: Evaluation of the efficacy of empirical aminoglycoside in critically ill patients with bloodstream infections caused by extended-spectrum β-lactamase producing Enterobacteriaceae (ESBL-E BSI). Methods: Patients treated between 2011 and 2018 for ESBL-E BSI in the ICU of six French hospitals were included in a retrospective observational cohort study. The primary endpoint was mortality on day 30. Results: Among 307 patients, 169 (55%) were treated with empirical aminoglycoside. Death rate was 40% (43% with vs. 39% without aminoglycoside, p = 0.55). Factors independently associated with death were age ≥70 years (OR: 2.67; 95% CI: 1.09–6.54, p = 0.03), history of transplantation (OR 5.2; 95% CI: 1.4–19.35, p = 0.01), hospital acquired infection (OR 8.67; 95% CI: 1.74–43.08, p = 0.008), vasoactive drugs >48 h after BSI onset (OR 3.61; 95% CI: 1.62–8.02, p = 0.001), occurrence of acute respiratory distress syndrome (OR 2.42; 95% CI: 1.14–5.16, p = 0.02), or acute renal failure (OR 2.49; 95% CI: 1.14–5.47, p = 0.02). Antibiotherapy appropriateness was more frequent in the aminoglycoside group (91.7% vs. 77%, p = 0.001). Rate of renal impairment was similar in both groups (21% vs. 24%, p = 0.59). Conclusions: In intensive care unit (ICU) patients with ESBL-E BSI, empirical treatment with aminoglycoside was frequent. It demonstrated no impact on mortality, despite increasing treatment appropriateness.

Day case surgery

2021 ◽  
pp. 941-960
Keyword(s):  
Day Surgery ◽  
Day Case ◽  
Day Case Surgery ◽  
Hospital Acquired Infection ◽  
Case Surgery ◽  
History Of ◽  
The Common ◽  
Definition Of ◽  
Hospital Acquired ◽  
Stay Hospital

This chapter studies day case surgery. The definition of day case surgery is the planned day admission of a patient to hospital for a surgical procedure, after which there is subsequent successful and safe discharge back home on the same day. The main rationale behind day surgery is to get patients discharged home following their operations in a safe and timely manner instead of spending prolonged periods within the hospital as an inpatient. This has significant implications, including reducing hospital stay, hospital-acquired infection, and healthcare-related costs while also improving patient experience and service efficiency. Surgical, anaesthetic, and patient factors should be considered for successful day case surgery. The chapter then traces the history of day case surgery, before detailing the common day surgery procedures.

scholarly journals Comparison of psychological symptoms between infected and non-infected COVID-19 health care workers

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nami Mohammadian Khonsari ◽  
Gita Shafiee ◽  
Atefeh Zandifar ◽  
Sahar Mohammad Poornami ◽  
Hanieh-Sadat Ejtahed ◽  
...  
Keyword(s):  
Health Care ◽  
High Risk ◽  
Health Care Workers ◽  
Psychological Symptoms ◽  
Infection Prevalence ◽  
Validated Questionnaire ◽  
Care Workers ◽  
Increased Risk ◽  
History Of ◽  
Anxiety Depression

Abstract Background Studies have shown that health care workers (HCWs), as front liners of the coronavirus (COVID-19) pandemic, are at high risk for psychological symptoms, but few studies have compared these symptoms in infected and non-infected HCWs. This study compares psychological symptoms among these two groups. Methods In this cross-sectional study, 938 HCWs from various medical fields working in the leading general hospitals of Alborz province, Iran, were selected using a multistage sampling method. The participants had contact with COVID-19 patients. Post-traumatic stress disorder-8 (PTSD-8) is a validated questionnaire that we used to evaluate PTSD symptoms along with its subscales, including intrusion, avoidance, and hypervigilance. Also, the Depression, Anxiety, and Stress Scale-21 questionnaire was used to assess the severity of the aforementioned conditions in HCWs. Multivariate logistic regression was used to compare psychological symptoms in infected and non-infected HCWs. Results Among 938 included HCWs, 55 had a history of confirmed COVID-19 infection. Prevalence of stress, anxiety, depression, intrusion, hypervigilance, and avoidance among infected HCWs were significantly higher in comparison to non-infected HCWs. In the multivariate logistic model, history of COVID-19 infection among HCWs was associated with a significantly increased risk of anxiety, depression, stress, intrusion, hyper-vigilance, and avoidance. Conclusion The present study showed that the HCWs with COVID-19 infection were at a high risk of displaying psychological symptoms. Therefore, it is also necessary to develop psychological support and interventions for HCWs, especially those who got infected with the virus.

Nursing Considerations for Patients With HIV in Critical Care Settings

2020 ◽  
Vol 31 (3) ◽  
pp. 308-317
Author(s):  
Lucy Graham ◽  
Mary Beth Flynn Makic
Keyword(s):  
Critical Care ◽  
Antiretroviral Therapy ◽  
People Living With Hiv ◽  
Secondary Complications ◽  
Qt Intervals ◽  
Appropriate Treatment ◽  
Increased Risk ◽  
History Of ◽  
Living With Hiv

Infection with HIV is a chronic condition that requires daily medication to suppress viral replication. With appropriate treatment, people living with HIV have a life expectancy approaching that of the general population. However, they are at increased risk for comorbidities including cardiovascular disease, renal disease, type 2 diabetes, neurologic conditions, and cancers, often with worse outcomes than in patients without HIV. When they are admitted to critical care settings, care considerations, particularly regarding antiretroviral therapy, must be addressed. Antiretroviral therapy is critical for successful management of HIV infection and should be continued when possible during intensive care unit stays. However, many antiretroviral regimens result in drug-drug interactions, adverse drug-related events, and secondary complications such as insulin resistance and prolonged QT intervals. Critical care nurses have unique opportunities to provide safe, unbiased, and compassionate care that promotes health for a population of people who have a history of being stigmatized.

Establishment of a hospital-acquired infection surveillance system in a teaching hospital in Rwanda

2016 ◽  
Vol 12 (3) ◽  
Author(s):  
Stephanie Lukas ◽  
Unarose Hogan ◽  
Viatory Muhirwa ◽  
Caroline Davis ◽  
John Nyiligira ◽  
...  
Keyword(s):  
Teaching Hospital ◽  
Surveillance System ◽  
Hospital Length Of Stay ◽  
World Health ◽  
Chest Drain ◽  
Hospital Acquired Infection ◽  
Resource Setting ◽  
Infection Surveillance ◽  
Increased Risk ◽  
Hospital Acquired

Hospital-based infection surveillance and control programs can reduce hospital acquired infection (HAI) prevalence. In resource-limited countries, HAI surveillance is challenging to implement due to inadequate or lacking laboratory infrastructure and trained personnel. A HAI surveillance system was implemented in a teaching hospital in Rwanda. A multi-disciplinary team developed a point-prevalence HAI surveillance tool based on World Health Organization (WHO’s) criteria and conducted surveillance on all inpatient units from September 2013 to March 2014. The baseline HAI rate was 15.1%. Highest HAI rates were found in intensive care unit (ICU) (50.0%), Neonatal ICU (23.1%) and Orthopedics/burn unit (37.3%). Factors significantly associated with increased risk of developing HAIs included surgery within the past month (odds ratio [OR] 2.75, 95%CI: 1.40, 5.40), use of a urinary catheter (OR 2.10, 95%CI: 1.05, 4.25), use of mechanical ventilator (OR 3.14, 95%CI: 1.01, 9.74), and use of chest drain, naso-gastric tube, external fixator (OR=3.93). Longer hospital length of stay was also significantly associated with a risk of HAI (OR 1.02). It is feasible in a low-resource setting to establish HAI surveillance and obtain an accurate HAI rate. The surveillance information can inform prioritization of infection prevention efforts.

scholarly journals Impact of Hand Hygiene on Hospital-Acquired Infection Rate in Neuro Trauma ICU at a Level 1 Trauma Center in the National Capital Region of India

2021 ◽  
Author(s):  
Sandeep Boora ◽  
Parul Singh ◽  
Roshni Dhakal ◽  
Dennis Victor ◽  
Jacinta Gunjiyal ◽  
...  
Keyword(s):  
Health Care ◽  
Hand Hygiene ◽  
Cost Effective ◽  
World Health ◽  
National Capital Region ◽  
Hospital Acquired Infection ◽  
Cost Effective Method ◽  
Care Workers ◽  
National Capital ◽  
Hospital Acquired

Abstract Introduction Compliance to hand hygiene (HH) is an important measure in preventing infections to patients in health-care settings. Wellness and safety of patients and health-care workers (HCWs) can be achieved by promoting best practices in infection control through education and advocacy. Aims and Objectives To assess the compliance to HH among all cadres of HCWs and its association with hospital-acquired infection (HAI) in patients. Materials and Methods A prospective, observational study was conducted for a period of 5 years (January 2014 to December 2018) in Neuro Trauma intensive care unit. A standard checklist based on World Health Organization’s 5 Moments for Hand Hygiene was used as a tool to measure the HH compliance. Results HAI rate was found to be directly proportional to the compliance to HH. Reduction in HAI rates was reported when there was an increase in HH compliance. HAI of 4.25% was found to be lowest in the year 2015 with the compliance to HH of 63.65%. The HH compliance was also found to be highest (64.63%) in the year 2016 followed by 64.12% in the year 2017. During this period HAI rates were 4.35% and 4.8%, respectively. When the HH compliance declined in the year 2018 to 53.95%, there was an increase in the rate of HAI to 6.9%. Conclusion It could be concluded that HH compliance was associated with the decrease in HAIs. HH could be a simple and cost-effective method in the prevention of HAIs.

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