129 “Pop-Up” Specialist End of Life Ward For COVID-19—The Nottingham Experience

Background Our hospital trust anticipated an increased need for palliation and end of life care (EoLC) in patients with Covid-19 who were not appropriate for escalation and mechanical ventilation. Intervention A dedicated ward was opened as part of the trust-wide Covid-19 admissions pathway, led by geriatricians with palliative care input and staffed by relocated nursing and auxiliary personnel. Retrospective data was collected for consecutive patients admitted to the ward between 3rd April and 26th May 2020 and qualitative data regarding staff experience using a questionnaire. Result Of the 168 patients (55% male) admitted, 31.5% came directly from Emergency Department, 17.3% from admission areas and the remainder from inpatient wards. Time spent on the ward ranged from 10 minutes to 17 days (median length of stay 43 hours). 75% had Clinical Frailty Scale score of 6 or more. 150 died with 75% naming Covid-19 as primary cause or contributing factor. Ward staff, who were not palliative care specialists, reported increased confidence in many aspects of palliation including assessing comfort, relieving symptoms, prescribing and administering anticipatory medications and in supporting and communicating with relatives. Staff apprehension about working on a Covid ward eased once the ward was established. Qualitative themes emerging from staff feedback included: professional competency, communication, prioritisation, team work, emotional response, care and consistency in a time of change. Discussion The pathway and referral system ensured that our ward cared for appropriate older patients living with frailty. The formation of a specialist unit over a short period of time created a series of logistical and management challenges. The emotional burden felt by staff was also prominent in feedback. These challenges were outweighed by the personal and professional development of staff coupled with the strong sense of teamwork, pride and enthusiasm felt in providing high quality care.

Psychological Distress and Health-Related Quality of Life in Public Sector Personnel

Background: This study has assessed health-related quality of life (HRQoL) and psychological distress between public sector professional groups. Methods: Short Form-36 Health Survey (SF-36) and Hospital Anxiety and Depression Scale (HADS) were administered to healthcare personnel, schoolteachers, and municipality and regional personnel in the region of Western Greece. Mean scores on all SF-36 dimensions and HADS were compared among these professional groups as well as with the Greek national norms to assess if there were significant differences between our study sample and the general population. Results: Healthcare personnel reported significantly lower SF-36 scores than teachers and municipality employees. Women reported poorer HRQoL than men on all SF-36 dimensions. This overall low score for health care workers masks the fact that male health care workers, primarily medical doctors, actually scored better than women, primarily nurses and auxiliary personnel. Average mean scores on all SF-36 dimensions reported by nurses and auxiliary personnel in healthcare were considerably lower than the ones from employees in all other occupational types. The impact on HRQoL observed mainly in vitality, social functioning and mental health was important. Many participants have shown psychological burden and depression. Conclusions: The health inequalities among healthcare employees are significant. This study is important to suggest taking measures for improving the HRQoL of health workers.

Application of Lean 6s Methodology in an Engineering Education Environment during the SARS-CoV-2 Pandemic

In this work, the application of the Lean 6S methodology is exposed, which includes the Safety-Security activity in response to the demands caused by the epidemiological situation due to exposure to SARS-CoV-2, as well as its implementation through a standardized process in n higher education environment in the engineering field. The application of methodologies based on lean principles in the organizational system of an educational institution, causes an impact on the demands of organizational efficiency, where innovation and continuous improvement mark the path to success. The Lean 6S methodology, based on the development of six phases, guarantees, thanks to the impact of all its phases and especially of three of them: cleaning, standardize and safety, the control of the health risk against SARS-CoV-2. This guarantee is achieved through the permanent review of safety in the workplace. The areas of selected implementation to verify the effect have been the essential spaces for the development of the teaching activity: center accesses, learning rooms and practical laboratories. The laboratories are adapted to the security and organization conditions that are required in the regulations required by the Occupational Risk Prevention Services against exposure to SARS-CoV-2, since the appropriate protective equipment for the risk level is reviewed, the ordering of the workstations, the class attendance through the shifts organization and the rearrangement of the common places where the maintenance of a minimum interpersonal safety distance between the teaching staff, auxiliary services and students is guaranteed. The effort of the teaching staff in terms of following the established rules is notably increased. To balance this dedication, it is necessary to increase and rely on auxiliary personnel who guarantee rules compliance control in different spaces than the classroom and the laboratory.

SARS-COV-2 Transmission in México´s Dental Practice: Measures, Clinical Implications and Management

The SARS-COV2 outbreak began as a zoonotic transmission, with Chinese horseshoe bats (Rhinolophus sinicus) and pangolins being the most likely origin of the infection. Once the patient has been infected, the virus is significantly present in the nasopharyngeal and salivary secretions. The professionals who are most directly exposed to the risk of contagion are dentists since the evolutionary process of virus infection occurs due to the inhalation of particles in the dental environment, the formation of aerosols during practice, and what is more important, in the expectorations emitted by the patients. Therefore, it is necessary to act diligently in professional practice, as well as take the necessary preventive measures to avoid the spread of the infection. The appearance of this new disease forces us to modify all the sanitary measures that have been taken concerning dental care by the professional, as well as auxiliary personnel and the protection of patients, requiring strict sanitary control by the authorities of health. In the university environment, the changes that must be made to allow an open channel of communication between students, teaching, administrative and hygiene personnel must continue to prevent this and future diseases. The aim of this article is to propose a protocol for dental clinical care, considering the real conditions and needs that prevail in our practice, highlighting the risk and preventive measures that the dental professional must consider, as well as the management of patients.

Dentistry in the post covid-19 world- are we prepared?

Background: Covid -19 pandemic has affected dental profession tremendously and has placed dentists and dental professionals in the very high exposure risk jobs. Practicing dentistry requires the provider to be in close proximity of the patients and their oral cavity. Many dental procedures tend to generate aerosols owing to the use of an air rotor or highspeed handpiece. The impact of Covid –19 on dentistry, like all other professions is ever evolving and newer guidelines are published almost every day. The authors also examine the ethical, psychological and financial implications of this pandemic to the dental professionals as well as patients. The important role of organized dentistry is highlighted in facilitating change to adapt to the new norm and implement the safer practice guidelines. Conclusions: The authors conclude that significant changes need to be undertaken to protect patients, dental professionals, auxiliary personnel.

RADIATION EXPOSURE DURING SPINE SURGERY USING C-ARM FLUOROSCOPY

ABSTRACT Objective: To evaluate the radiation dose received by staff in spine surgeries, including those who are not considered occupationally exposed workers. Methods: All spinal surgeries performed in the same department during a period of 12 months were evaluated with regard to the exposure of surgeons, scrub nurses, and auxiliary personnel working in the operating room to radiation from C-arm fluoroscopy. Radiation was measured by 15 film badge dosimeters placed on the professionals’ lapels, gloves, and room standardized sites. The films were analyzed in the dosimetry laboratory by collections per period. Results: During the 12 months, 81 spinal surgeries were performed by the same team, with surgical times ranging from 1 to 6 hours. The total radiation dose ranged from 0.16 mSv to 2.29 mSv depending on the dosimetry site. The most exposed site was the wrist of the main surgeon. Conclusion: The results showed that in the spinal surgeries in our setting, the radiation doses are low and within legal limits. Nevertheless, constant training of professionals is essential for radiation protection of medical staff and patients. Level of evidence I/b, exploratory cohort study.

THE COST OF LABOR AND PREVENTION OF DENTOALVEOLAR ANOMALIES WITH THE USE OF PLATES WITH ARTIFICIAL TEETH WHEN PREZHDEVREMENNOY LOSS OF DECIDUOUS TEETH

The calculations of labor intensity and cost of prevention of dentoalveolar anomalies in children with premature loss of teeth using a removable plate with artificial teeth. The method of calculations is described in detail, the differentiated values of labor intensity and cost of different stages of production of the plate and its use are given. The complexity of manufacturing a removable plate with artificial teeth and the corresponding observation by an orthodontist doctor in the process of preventing deformation in a child with premature loss of temporary teeth is an average of 7.5 hours; direct labor costs of the doctor are 4.3 hours, dental technician-1.9 hours. The cost of production of the plate and subsequent treatment is 13 370 rubles, among which 80% is the remuneration of the main and auxiliary personnel with tax charges.

Oral Cancer Awareness among Auxiliary Personnel of Dental College in Bhopal City, India

Background: Oral cancer prevalence is high globally. Dental auxiliary staff who work aside the dentist is the first to come in contact with service seeker. Hence awareness regarding oral cancer in consequences is an essential modality in these personnel’s. Methodology: This study was conducted to evaluate the awareness among dental auxiliary staff about oral cancer of two dental colleges of Bhopal city. Sampling frame included the dental auxiliary staff from the two dental colleges. A structured questionnaire was used for collection of data. The collected data were coded, and a statistical analysis was carried out by using Statistical Package of Social Science (SPSS 20). Result: In this study, it was observed 52% females were aware of examining patients mouth during admission. 50% Females advice to examined tissues of cheek, tongue and palate while assessing oral cancer. 52.1% females opinion of risk factor for oral cancer would be tobacco chewing, tobacco smoking, having alcohol and spicy food. Conclusion: The study conducted among dental auxiliary staff to assess the awareness regarding oral cancer which will help in early diagnosis of disease and prevent any further complication.