Exposure to SARS-CoV-2 in Hospital Environment: Working in a COVID-19 Ward Is a Risk Factor for Infection

Aims. Health care workers (HCWs) are at risk of acquiring the Severe Acute Respiratory Syndrome Coronavirus 2 Infection (SARS-CoV-2). The aim of the study is to determine the SARS-CoV-2 positivity rates during the first epidemiologic peak among HCWs of a south Belgian hospital and to identify risks factors for infection. Methods. All hospital staff who worked during the first epidemiological peak were asked to answer a questionnaire regarding demographical data, function, type of working unit, type of contact with patients, eventual symptomatology, and the positivity of reverse transcription-polymerase chain reaction (RT-PCR) testing or immunoassay. Results. A total of 235 questionnaires were collected; 90 (38%) HCWs tested positive for SARS-CoV-2 from either RT-PCR or immunoassay testing. The positivity rate of HCWs between wards was statistically different (p = 0.004) and was higher in COVID-19 wards than Intensive Care Unit (ICU) and Emergency Department (ED). A total of 114 (49%) HCWs presented SARS-CoV-2-compatible symptomatology; 79 (88%) were positive on either RT-PCR or immunoassay testing; 74 (37%) HCWs were unable to work during the studied period; 5 were hospitalized. No deaths were reported. Multivariate logistic regression modeling showed that having symptoms was highly associated with test positivity (OR 23.3, CI 11.1, 53.1, p-value < 0.001). Working in a COVID-19 ward against working in ICU or ED was also predictive of positivity among HCWs (OR 3.25, CI 1.50, 7.28, p-value = 0.003). Discussion and Conclusions. This study shows a higher positivity rate compared to already reported positivity rates among HCWs. Reported differences in positivity rates depend on many factors, such as local crisis intensity, screening strategy, training in use of self-protective equipment, and study selection bias. HCWs working in COVID-19 wards, in comparison to ED and ICU, seemed at greater risk of being infected in this study. This could be explained by the disparity of HCWs’ experience in handling self-protective equipment and knowledge in infection prevention. Hence, care should be taken in proper training for less-experienced HCWs during hospital epidemics. The latter could increase HCWs’ protection and consequently decrease work absenteeism, ensuring enhanced continuity of patient care during hospital crisis. Rapid quarantine of symptomatic HCWs could reduce contamination rates, as having symptoms was highly associated with test positivity in this study.

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FAKTOR-FAKTOR YANG MEMPENGARUHI KEPATUHAN PENGGUNAAN ALAT PELINDUNG DIRI (APD) PERAWATPADA MASA PANDEMI COVID-19 DI INSTALASI GAWAT DARURAT RUMAH SAKIT UMUM DAERAH dr. ZUBIR MAHMUD

PREPOTIF : Jurnal Kesehatan Masyarakat ◽

10.31004/prepotif.v5i2.2434 ◽

2021 ◽

Vol 5 (2) ◽

pp. 1243-1253

Author(s):

Putri Nahrisah ◽

Arista Ardila Arista Ardilla

Keyword(s):

Personal Protective Equipment ◽

Health And Safety ◽

Hospital Environment ◽

P Value ◽

Protective Equipment ◽

Cross Sectional ◽

Exact Test ◽

Safety And Health ◽

Quantitative Design ◽

Work Accidents

Hospital Occupational Health and Safety (K3RS) are all activities to ensure and protect the safety and health of hospital human resources, patients, patient companions, visitors, and the hospital environment through efforts to prevent work accidents and occupational diseases in hospitals. This study aims to determine the factors related to compliance with the use of personal protective equipment (PPE) for nurses during the COVID-19 pandemic in the ER RSUD dr. Zubir Mahmud 2021. The research design used was a quantitative design with a cross sectional approach. The population is all nurses who work in the ER dr. Zubir Mahmud as many as 29 and the sample in this study as many as 29 respondents. Collecting data using a questionnaire. Data analysis using Chi-Squre and looking at Fisher's Exact Test. The results of research on the bivariate test show that there is a significant influence on the independent variables, namely the knowledge factor (p-value = 0.008), attitude (p-value = 0.006), availability (p-value =0.000) and supervision (p-value =0.001). and there was no significant effect, namely the education factor (p-value = 0.622) and years of service (p-value = 0.139) with the dependent variable being the compliance with the use of personal protective equipment (PPE) by nurses during the Covid-19 pandemic.Suggestions in this study are hospitals must make clear SOPs about the use of PPE and increase vigilance during the pandemic.

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A FOCUSED EDUCATIONAL PROGRAM FOR FRONT-LINE HEALTH CARE WORKERS DURING COVID -19 OUTBREAK IMPROVES MENTAL HEALTH

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v71i5.5541 ◽

2021 ◽

Vol 71 (5) ◽

pp. 1870-74

Author(s):

Urwah Ikhlaq ◽

Madiha Umair ◽

Komal Baloch ◽

Imran Ansari ◽

Jawed Abu Baker ◽

...

Keyword(s):

Personal Protective Equipment ◽

Educational Program ◽

Hospital Staff ◽

Anxiety And Depression ◽

P Value ◽

Protective Equipment ◽

Protective Measures ◽

Major Depression Inventory ◽

Health Organization ◽

Severe Anxiety

Objective: To determine whether an educational program on personal protective measures can reduce anxiety and depression in Hospital workers exposed to COVID-19. Study Design: Quasi-experimental study. Place and Duration of Study: COVID Units & Emergency Room, from May to Jul 2020. Methodology: Educational tool based on World Health Organization and Pan American Health Organization guidelines including videos on Personal Protective Equipment usage was delivered to hospital staff assigned to areas with COVID-19 patients. Likert scale, Generalised Anxiety Disorder-7 score and Major Depression Inventory were used. Results: 100 hospital staff were included. About 40% doctors, 41% Nurses. None had preexisting anxiety or depression. 11% reported COVID-19, 46% reported quarantine, and 91% reported contact. About 93% stated insufficient knowledge of usage of personal protective equipment and 35% reported inadequate provision of personal protective equipment. Median score on the likert scale was 5 (IQR 4-7). Mean generalized anxiety disorder score was 6.48 ± 3.4, which improved to 4.65 ± 2.7 post session, p-value <0.001. 41% reported minimal, 34% mild, 24% moderate and 1% severe anxiety. Post session, 62% reported minimal Anxiety, 33% mild, 5% moderate and 0% severe anxiety. Mean major depression inventory score was 16.10 ± 7.05 which reduced to 13.58 ± 5.84, p-value <0.001. Pre-session 59% reported „no/doubtful depression‟, 40% mild, 1% moderate depresssion, while post-session 85% reported „no/doubtful‟, 15% mild and none had moderate/severe depression. Conclusion: We found an educational program that provided information on personal protective measures significantly reduced anxiety and depression in front-line workers during COVID-19 pandemic.

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Preparedness and attitude toward personal protective equipment among house officers during COVID-19 pandemic in Egypt

Journal of Public Health ◽

10.1093/pubmed/fdab078 ◽

2021 ◽

Author(s):

Asmaa Ahmed Sayed ◽

Marwa Mostafa Ahmed ◽

Inas Talaat Elsayed ◽

Soliman Saeed ◽

Alsallout Inas ◽

...

Keyword(s):

Personal Protective Equipment ◽

Odds Ratio ◽

Hospital Staff ◽

Survey Study ◽

P Value ◽

Protective Equipment ◽

Web Based ◽

The World ◽

The Mean ◽

Low Levels

Abstract Background Coronavirus disease 2019 (COVID-19) struck the world by surprise by the rising numbers that required prompt governmental and hospital staff reaction to the ongoing crisis. A robust preparedness and personal protective equipment (PPE) were yet to be regarded as our best plan. Methods A survey study was conducted on 254 Egyptian house officers using an anonymous web-based questionnaire that was filled using Google Forms after obtaining online informed consent. Results The mean age of the participants was 25 years. Only 28.74% of the house officers were categorized as having a good preparedness, while 85.83% of them have a good PPE attitude. The preparedness and willingness were significantly associated with the overall worry related to the pandemic (P value = 0.012). Fear of contracting COVID-19 infection negatively affected their preparedness by 60% (odds ratio (OR) 0.40, 95% confidence interval (CI), 0.17–0.93, P value = 0.034). The House officers with family members at-risk for severe COVID-19 were less likely to be prepared and willing by 70% (OR 0.30, 95% CI 0.15–0.60, P value = 0.001). The house officers with good preparedness and willingness to deal with COVID-19 seemed to have a good PPE attitude (OR 11.48, 95% CI 2.43-54.34, P value = 0.002). Conclusion A significant number of house officers expressed low levels of preparedness, while most of them have a good PPE attitude.

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The Protective Effect of Metformin against Oxandrolone-Induced Infertility in Male Rats

Current Pharmaceutical Design ◽

10.2174/1381612826666201029101524 ◽

2020 ◽

Vol 26 ◽

Author(s):

Abdulqader Fadhil Abed ◽

Yazun Bashir Jarrar ◽

Hamzeh J Al-Ameer ◽

Wajdy Al-Awaida ◽

Su-Jun Lee

Keyword(s):

Gene Expression ◽

Male Infertility ◽

Protective Effect ◽

Histological Examination ◽

Sperm Count ◽

Serum Testosterone ◽

Male Rats ◽

P Value ◽

Protective Effects ◽

Rt Pcr

Background: Oxandrolone is a synthetic testosterone analogue that is widely used among bodybuilders and athletes. However, oxandrolone causes male infertility. Recently, it was found that metformin reduces the risk of infertility associated with diabetes mellitus. Aim: This study aimed to investigate the protective effects of metformin against oxandrolone-induced infertility in male rats. Methods: Rats continuously received one of four treatments (n=7) over 14 days: control DMSO administration, oxandrolone administration, metformin administration, or co-administration of oxandrolone and metformin. Doses were equivalent to those used for human treatment. Subsequently, testicular and blood samples were collected for morphological, biochemical, and histological examination. In addition, gene expression of the testosterone synthesizing enzyme CYP11A1 was analyzed in the testes using RT-PCR. Results: Oxandrolone administration induced male infertility by significantly reducing relative weights of testes by 48%, sperm count by 82%, and serum testosterone levels by 96% (ANOVA, P value < 0.05). In addition, histological examination determined that oxandrolone caused spermatogenic arrest which was associated with 2-fold downregulation of testicular CYP11A1 gene expression. However, co-administration of metformin with oxandrolone significantly ameliorated toxicological alterations induced by oxandrolone exposure (ANOVA, P value < 0.05). Conclusion: Metformin administration protected against oxandrolone-induced infertility in male rats. Further clinical studies are needed to confirm the protective effect of metformin against oxandrolone-induced infertility among athletes.

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Infection control practices and challenges in Pakistan during the COVID-19 pandemic: a multicentre cross-sectional study

Journal of Infection Prevention ◽

10.1177/17571774211012761 ◽

2021 ◽

pp. 175717742110127

Author(s):

Salma Abbas ◽

Faisal Sultan

Keyword(s):

Personal Protective Equipment ◽

Prevention And Control ◽

Infection Prevention ◽

Hospital Staff ◽

Cross Sectional Study ◽

Infection Prevention And Control ◽

Protective Equipment ◽

Cross Sectional ◽

Healthcare Facilities ◽

And Control

Background: Patient and staff safety at healthcare facilities during outbreaks hinges on a prompt infection prevention and control response. Physicians leading these programmes have encountered numerous obstacles during the pandemic. Aim/objective: The aim of this study was to evaluate infection prevention and control practices and explore the challenges in Pakistan during the coronavirus disease 2019 pandemic. Methods: We conducted a cross-sectional study and administered a survey to physicians leading infection prevention and control programmes at 18 hospitals in Pakistan. Results: All participants implemented universal masking, limited the intake of patients and designated separate triage areas, wards and intensive care units for coronavirus disease 2019 patients at their hospitals. Eleven (61%) physicians reported personal protective equipment shortages. Staff at three (17%) hospitals worked without the appropriate personal protective equipment due to limited supplies. All participants felt overworked and 17 (94%) reported stress. Physicians identified the lack of negative pressure rooms, fear and anxiety among hospital staff, rapidly evolving guidelines, personal protective equipment shortages and opposition from hospital staff regarding the choice of recommended personal protective equipment as major challenges during the pandemic. Discussion: The results of this study highlight the challenges faced by physicians leading infection prevention and control programmes in Pakistan. It is essential to support infection prevention and control personnel and bridge the identified gaps to ensure patient and staff safety at healthcare facilities.

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Enhancing Air Quality for Embedded Hospital Germicidal Lamps

Sustainability ◽

10.3390/su13042389 ◽

2021 ◽

Vol 13 (4) ◽

pp. 2389

Author(s):

Jung-Shun Chen

Keyword(s):

Air Quality ◽

Hospital Staff ◽

Ventilation Rate ◽

Hospital Environment ◽

Design Stage ◽

Flow Noise ◽

Air Ventilation ◽

Air Disinfection ◽

Type 3

The indoor air of a hospital is always full of bacteria and viruses due to patients with different diseases. These bacteria and viruses could be highly infectious to the people in the hospital irrespective of their health conditions, and could be hazardous to the patients, their care takers, and hospital staff. Thus, keeping a good hospital air quality is very essential to the operation of the hospital. This study aims at enhancing ventilation of the interior lighting of hospitals with germicidal capabilities. Air disinfection is accomplished by adding the specially designed disinfecting filters and fans to existing embedded lamps in the hospitals. The embedded lamp has a square shape of 601 mm in width and 112 mm in thickness. In the design stage, the air flow inside the embedded lamp with the added filters and fans was investigated by numerical simulation using a computational fluid dynamics (CFD) tool. Three designs, referred to as Types 1, 2, and 3, were evaluated using steady-state CFD flow simulations. The ventilation rate of the Type 1 design was about 251.9 CMH, and 348.3 CMH for the Type 2 design by increasing the fan outlet area. However, even though the ventilation was increased by 34%, the flow field of the Type 2 design was not uniform, resulting in flows being circulated around the side locations. Thus, the Type 3 design further treats this aspect by streamlining the outlet geometry and adding flow guiding vanes to reduce flow resistance and flow unsteadiness; the corresponding air ventilation rate reached 376.3 CMH. Hence, the Type 3 design was fabricated and tested. The test results confirm that the design not only has a higher ventilation rate but also operates under a smaller pressure drop, thus accomplishing the goal of providing good air quality in the hospital environment efficiently. Moreover, the associated flow noise is reduced by about 8 dBA. Hence, both an increase in the air ventilation rate and a reduction of noise are achieved simultaneously by the present method.

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Organisational change in hospitals: a qualitative case-study of staff perspectives

BMC Health Services Research ◽

10.1186/s12913-019-4704-y ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Chiara Pomare ◽

Kate Churruca ◽

Janet C. Long ◽

Louise A. Ellis ◽

Jeffrey Braithwaite

Keyword(s):

Health Systems ◽

Early Stage ◽

Organisational Change ◽

Hospital Staff ◽

Hospital Environment ◽

Structured Interviews ◽

Metropolitan Hospital ◽

The Face ◽

Negative Expectations

Abstract Background Organisational change in health systems is common. Success is often tied to the actors involved, including their awareness of the change, personal engagement and ownership of it. In many health systems, one of the most common changes we are witnessing is the redevelopment of long-standing hospitals. However, we know little about how hospital staff understand and experience such potentially far-reaching organisational change. The purpose of this study is to explore the understanding and experiences of hospital staff in the early stages of organisational change, using a hospital redevelopment in Sydney, Australia as a case study. Methods Semi-structured interviews were conducted with 46 clinical and non-clinical staff working at a large metropolitan hospital. Hospital staff were moving into a new building, not moving, or had moved into a different building two years prior. Questions asked staff about their level of awareness of the upcoming redevelopment and their experiences in the early stage of this change. Qualitative data were analysed using thematic analysis. Results Some staff expressed apprehension and held negative expectations regarding the organisational change. Concerns included inadequate staffing and potential for collaboration breakdown due to new layout of workspaces. These fears were compounded by current experiences of feeling uninformed about the change, as well as feelings of being fatigued and under-staffed in the constantly changing hospital environment. Nevertheless, balancing this, many staff reported positive expectations regarding the benefits to patients of the change and the potential for staff to adapt in the face of this change. Conclusions The results of this study suggest that it is important to understand prospectively how actors involved make sense of organisational change, in order to potentially assuage concerns and alleviate negative expectations. Throughout the processes of organisational change, such as a hospital redevelopment, staff need to be engaged, adequately informed, trained, and to feel supported by management. The use of champions of varying professions and lead departments, may be useful to address concerns, adequately inform, and promote a sense of engagement among staff.

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Evaluation of the effectiveness of preventive and anti-epidemic measures to prevent the spread of COVID-19 among patients and medical personnel of an antitubercular hospital during the pandemic

Sanitarnyj vrač (Sanitary Inspector) ◽

10.33920/med-08-2102-01 ◽

2021 ◽

pp. 8-14

Author(s):

Temirov Nemat Moidunovich ◽

Mamyrova Kanykey Kanybekovna ◽

Abdimomunova Begimay Toktobolotovna ◽

Satybaldieva Ayzirek Topchubaevna ◽

Zholdoshev Saparbay Tezekbaevich

Keyword(s):

High Efficiency ◽

Medical Personnel ◽

Hospital Staff ◽

Protective Equipment ◽

Tuberculosis Control ◽

Control Center ◽

Adequate Ventilation ◽

Sources Of Infection ◽

Coronavirus Infection ◽

Spread Of Infection

The commonality of mechanisms and ways of transmission of new coronavirus infection and tuberculosis increases the risk of spreading pathogens and determines common preventive approaches. The aim of the work was to assess the effectiveness of preventive and anti-epidemic measures to prevent the spread of COVID-19 among patients and medical personnel of an antitubercular hospital during the pandemic. Given the specifics of TB hospital developed and implemented a complex of measures to prevent the spread of COVID-19, which includes the identification and isolation of sources of infection, disinfection of air and adequate ventilation, disinfection of surfaces, use of personal protective equipment. The article describes the group morbidity of COVID-19 patients in an antitubercular hospital, which was caused by the introduction of infection into the hospital by patients in the incubation period. Timely measures made it possible to localize the situation and prevent the widespread spread of infection. The complex of measures for the protection of medical personnel has shown its high efficiency, which was manifested in the absence of cases of illness of personnel working in the «red zone». The absence of a consistent epidemic spread of the new coronavirus infection COVID-19 among patients and hospital staff of the R.G. Bauer Jalal-Abad Regional Tuberculosis Control Center allows us to use the described experience of conducting preventive and anti-epidemic measures in medical organizations of this type.

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Attractions to Fuel the Imagination: Reframing Understandings of the Role of Distraction Relative to Well-Being in the Pediatric Hospital

HERD Health Environments Research & Design Journal ◽

10.1177/1937586718810878 ◽

2018 ◽

Vol 12 (2) ◽

pp. 130-146 ◽

Cited By ~ 1

Author(s):

Rebecca McLaughlan ◽

Ahmed Sadek ◽

Julie Willis

Keyword(s):

Well Being ◽

Hospital Staff ◽

Hospital Environment ◽

Photo Elicitation ◽

Pediatric Hospital ◽

Waiting Room ◽

Positive Feelings ◽

Definition Of ◽

Patient Resistance ◽

Outpatient Appointments

Objective: Ulrich’s (1991) definition of “positive distraction” includes that which “elicits positive feelings and holds attention,” implying that the capacity of an environmental feature to hold attention is a necessary component. This article examines whether, in the context of a pediatric hospital, a distraction needs to “hold attention” to secure positive benefits for patient well-being. Background: Data collected from 246 patients at Melbourne’s Royal Children’s Hospital (Australia) revealed a discrepancy between what children and young people told us they did, and valued, within the hospital, relative to the time they spent engaging in, or paying attention to, these same features. This motivated a closer interrogation of the relationship between well-being, distraction, and socialization within the pediatric context. Method: Data were collected using a mixed-methods approach that included 178 surveys, 43 drawings contributed by patients/siblings within the outpatient waiting room, 25 photo-elicitation interviews with patients, and 100 hr of spatial observations within public and waiting room spaces. This was supplemented by interviews with architects and hospital staff. Conclusions: The mechanism by which we have understood positive distraction to contribute to well-being within the pediatric hospital environment is more complex than existing models accept. Within this context, environmental features that can positively transform expectations of visiting the hospital—that can ignite the imagination and incite a desire to return—can offer significant benefits to well-being. This is particularly relevant in the context of absenteeism from outpatient appointments and in reducing patient resistance to future, or ongoing, treatments.

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Using surgical wrapping material for the fabrication of respirator masks

10.1101/2020.04.10.20060632 ◽

2020 ◽

Author(s):

Johanna H Meijer ◽

Joric Oude Vrielink

Keyword(s):

Personal Protective Equipment ◽

Healthcare Professionals ◽

Hospital Staff ◽

Clinical Staff ◽

Surgical Instruments ◽

Protective Equipment ◽

Bottom Up ◽

Filter Efficiency

AbstractGiven the current shortage of respirator masks and the resulting lack of personal protective equipment for use by clinical staff, we examined bottom-up solutions that would allow hospitals to fabricate respirator masks that: (i) meet requirements in terms of filtering capacities, (ii) are easy to produce rapidly and locally, and (iii) can be constructed using materials commonly available in hospitals worldwide. We found that Halyard H300 material used for wrapping of surgical instruments and routinely available in hospitals, met these criteria. Specifically, three layers of material achieved a filter efficiency of 94%, 99%, and 100% for 0.3 μm, 0.5 μm, and 3.0 μm particles, respectively; importantly, these values are close to the efficiency provided by FFP2 and N95 masks. After re-sterilization up to 5 times, the filter’s efficiency remains sufficiently high for use as an FFP1 respirator mask. Finally, using only one layer of the material satisfies the criteria for use as a ‘surgical mask’. This material can therefore be used to help protect hospital staff and other healthcare professionals who require access to suitable masks but lack commercially available solutions.

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