Transmission of COVID-19 on an Inpatient Hospital Prison Unit

Background: Prison populations have been disproportionally affected by COVID-19, partly due to challenges related to social distancing. Data on viral transmission dynamics in inpatient prison units remain limited. The Ohio State University Wexner Medical Center (OSUWMC) has a 24-bed inpatient prison unit in collaboration with the Ohio Department of Rehabilitations and Corrections (ODRC). The unit has 5 shared rooms holding 4 patients each and 4 single-patient rooms. Several cases of inpatient transmission of COVID-19 were identified on the inpatient prison unit. Methods: An IRB-approved retrospective chart review was conducted to evaluate inpatient transmission dynamics of hospital-acquired (HCA) COVID-19. All ODRC patients admitted from March 1 to April 24, 2020, were included. Patients assigned to the prison unit during their hospital stay were evaluated for potential HCA COVID-19, defined as a positive SARS-CoV-2 test ≥4 days after admission. Patient characteristics, testing data, symptoms, aerosol-generating procedures (AGPs), and room assignments were reviewed. Healthcare workers (HCWs) and correction officers (COs) working on the unit who tested positive during this period were identified. Results: In total, 142 ODRC patients were admitted during the study period and 89% had a positive SARS-CoV-2 testing prior to or during admission. Also, 61 patients (43%) were assigned to the prison unit. Moreover, 8 patients on the unit met potential HCA COVID-19 definition with 7 linked to 3 distinct clusters. Also, 7 COs had COVID-19 (outside hospital exposure) and 5 HCWs acquired COVID-19 from patient exposure on the unit. In cluster 1, 4 patients admitted to the same room developed HCA COVID-19. A symptomatic index patient not tested on admission given an atypical presentation required CPAP and frequent nebulizer treatments. In cluster 2, 1 patient from cluster 1 was transferred to another room. The new roommate subsequently developed HCA COVID-19. In cluster 3, a symptomatic correctional officer was assigned to 2 patients in a shared room; the patients later developed HCA COVID-19. Conclusions: Three patient clusters of HCA COVID-19 on a prison unit were identified. Aerosol transmission potentially played a role in cluster 1. Inpatient transmission within the unit prompted updated guidance for ODRC admissions, including universal SARS-CoV-2 admission testing, excluding patients requiring AGPs from shared rooms, and preemptive isolation for patients from an ODRC facility experiencing a COVID-19 surge. Universal testing was quickly expanded to all inpatient admissions. HCWs and COs were also linked to inpatient transmission, highlighting the importance of strict infection control practices for patient populations who cannot socially distance.Funding: NoDisclosures: None

A Review on the Performance and Comfort of Stab Protection Armor

Stab-protective clothing is the most important component of safety equipment and it helps to save the lives of its wearers; therefore, it is designed to resist knife, nail, or needle attacks, especially to the upper body. In this paper, the essential requirements for stab-resistant armor are investigated based on an in-depth review of previous research and prototype test results. The combination of protection and comfort in armor vests is a particularly challenging task. Review of the state of the art technology responsible for the manufacture of stab-resistant clothes has revealed that their design and development should encompass the elements of comfort, freedom of movement, permeability, absorption, evaporation, and weight reductions to ensure excellent ergonomics and high wear comfort. The design as well as the production, weight, thickness, material types and properties, and the arrangement of scales determine the level of protection and comfort offered by stab-resistant vests. Currently, the production of stab-proof gear-based 3D printing technology is evaluated, using lightweight materials (aramid) in the form of segmented scales inspired by nature. As the protection performance and wear comfort of stab-proof gear is enhanced, the willingness of security, control, transport, custom, and correction officers to wear them can be significantly increased in an endeavor to ensure that fatal injuries will decrease significantly.

ADDRESSING THE NEEDS OF INCARCERATED INMATES WITH DEMENTIA: CREATING DEMENTIA-FRIENDLY PRISONS

U.S. prisons are experiencing a graying of their population, with many older inmates experiencing chronic conditions, including dementia. Older prisoners now represent 10% of the U.S. prison population and 18% of Illinois’ prison population. Aging inmates cost more to incarcerate due to their medical needs. Bureau of Prisons data estimate $881 million (19%) of its budget was spent to incarcerate aging inmates. Prisons are seeking solutions to address the unmet needs of older inmates, especially those with dementia. These older inmates with dementia face discrimination and exploitation within the prison population, and Correction Officers and clinicians lack training to understand and address their complex needs. Utilizing the Alzheimer’s Association’s, ACT on Alzheimer’s Toolkit we implemented four phases guiding communities’ adoption of dementia-friendly practices: we convened meetings with Illinois Department of Correction leaders, assessed community strengths and gaps by surveying prison wardens, analyzed findings and created an action plan to provide dementia training of prison staff to create a dementia friendly community. Our “Dementia-Friendly Prisons” program trains prison staff on understanding and providing supportive care and management to inmates with dementia, enabling staff to meet inmates’ needs, thereby creating an environment where inmates with dementia are safe and treated respectfully. Our program used an Appreciative Inquiry Four-D cycle approach (Discover-Dream-Design-Destiny) to engage and empower learners from a highly diverse workforce to develop into collaborative teams. Our program remedies a problem in the delivery of prison healthcare, serving a particularly vulnerable population and creates an adaptable model for other prisons and communities.

Step towards creating a community. The role of correction officers in prisons in prevention of prisoners’ self-harm and suicide behavior

The complexity of the problems and peculiarities of the population of prisoners, as well as the need for their re-socialization, create a framework for the roles, tasks and activities of correctional officers, who have the immediate task to correct convicts? behavior. Although correctional institutions in the description of their formal duties are treated as high priority element of their work, in practice it makes a double failure: in the course of prisoners? stay in the institution, self-harming and suicidal behavior is an unconstructive escape from the problems they are faced to, and on the other hand there is a high rate of recidivism which is a proof of unsuccessful prevention and treatment activities. Empowering correctional officers as important agents of convicts? change, must include not only their professional education for professional and focused work on the reduction of socially undesirable forms of behavior of prisoners, but also dealing with the problems of and vicarious trauma and burnout as common helpers? issue. Destructive behaviors as well as the recidivism are the undesirable result of unsuccessful treatment activities that affect adversely the family and the wider community. Creating a community of support during the period of the imprisonment, it is important for the growth and development of both sides in the process - convicted persons and educators. In this paper, we presented structured steps to achieve positive correctional effects in a broader spectrum of deviance: convicts? understanding, experiencing and reacting in the best possible way.

Correlates of Organizational Commitment Among Community Correctional Officers in China

There has been limited research on the correlates of organizational commitment among community correctional staff, regardless of the nation. Using data from 225 community correction officers from Hubei, China, this study examined community correctional staff commitment to their agencies and its predictors. The study found the majority of the respondents had commitment to their organizations. Organizational structure variables were more powerful than job characteristics in explaining the variance of the organizational commitment. All relationships between organizational structure variables, job characteristics, and organizational commitment were mediated by job satisfaction.