Changes in symptoms of dry eyes in health professionals with increased duration of wearing the mask

: In normal population and patient, the significant increase in dry eyes manifestations have been observed. Similarly, aggravated symptoms and complaints of dryness have also been observed in clinical and hospital staff by using a face mask for an extended time period. The purpose of the study was to observe the association between symptoms of dry eyes and the duration of using masks in health professionals.: An unspecified questionnaire was distributed using Google Forms through different social media platforms, asking each respondent to contribute to the survey. Data were collected from December 2021 to January 2021. Statistical analysis was performed using SPSS software. Statistical significance was considered if p-value was less than 0.05. A total of 39 responses was included for analysis in the study. There was a positive correlation between the frequency of the symptoms of dryness and the duration of using the mask. Similarly, the severity of the symptoms for dry eyes was strongly correlated with an increase in the frequency of symptoms for dry eyes.The finding reflects that the frequency of the dryness along with the severity will increase with the increase in the duration of wearing a mask. Moreover, it also suggests that cloth mask is the probable predisposing factor for the increase in the dry eye symptoms in this study.

Effects of Safety Zone Implementation on Perceptions of Safety and Well-being When Caring for COVID-19 Patients

Background In March 2020, the caseload of patients positive for COVID-19 in hospitals began increasing rapidly, creating fear and anxiety among health care workers and concern about supplies of personal protective equipment. Objectives To determine if implementing safety zones improves the perceptions of safety, well-being, workflow, and teamwork among hospital staff caring for patients during a pandemic. Methods A safety zone process was implemented to designate levels of contamination risk and appropriate activities for certain areas. Zones were designated as hot (highest risk), warm (moderate risk), or cold (lowest risk). Caregivers working in the safety zones were invited to complete a survey regarding their perceptions of safety, caregiver well-being, workflow, and teamwork. Each question was asked twice to obtain caregiver opinions for the periods before and after implementation of the zones. Results Significant improvements were seen in perceptions of caregiver safety (P < .001) and collaboration within a multidisciplinary staff (P < .001). Significant reductions in perceived staff fatigue (P = .03), perceived cross contamination (P < .001), anxiety (P < .001), and fear of exposure (P < .001) were also seen. Teamwork (P = .23) and workflow (P = .69) were not significantly affected. Conclusions Safety zone implementation improved caregivers’ perceptions of their safety, their well-being, and collaboration within the multidisciplinary staff but did not improve their perceptions of teamwork or workflow.

Does Seasonal Influenza Related Hospital Occupancy Surge Impact Hospital Staff Sickness Presenteeism and Productivity Costs?

Background—The workload of public hospital staff is heightened during seasonal influenza surges in hospitals serving densely populated cities. Such work environments may subject staff to increased risk of sickness presenteeism. Presenteeism is detrimental to nurses’ health and may lead to downstream productivity loss, resulting in financial costs for hospital organizations. Aims—This study aims to quantify how seasonal influenza hospital occupancy surge impacts nurses’ sickness presenteeism and related productivity costs in high-intensity inpatient metropolitan hospitals. Methods—Full-time nurses in three Hong Kong acute-care hospitals were surveyed. Generalized estimating equations (GEE) was applied to account for clustering in small number of hospitals. Results—A total of 71.3% of nurses reported two or more presenteeism events last year. A 6.8% increase in hospital inpatient occupancy rate was associated with an increase of 19% (1.19, 95% CI: 1.06–1.34) in nurse presenteeism. Presenteeism productivity loss costs between nurses working healthy (USD1983) and worked sick (USD 2008) were not significantly different, while sick leave costs were highest (USD 2703). Conclusion—Presenteeism prevalence is high amongst acute-care hospital nurses and workload increase during influenza flu surge significantly heightened nurse sickness presenteeism. Annual presenteeism productivity loss costs in this study of USD 24,096 were one of the highest reported worldwide. Productivity loss was also considerably high regardless of nurses’ health states, pointing towards other potential risk factors at play. When scheduling nurses to tackle flu surge, managers may want to consider impaired productivity due to staff presenteeism. Further longitudinal research is essential in identifying management modifiable risk factors that impact nurse presenteeism and impairing downstream productivity loss.

Understanding the Dynamics of Staff Reallocation to Clinical Practice During the First Wave of COVID-19 – a Qualitative Study

BackgroundDuring the COVID-19 pandemic, one responsive strategy to ensure hospital staff capacity was reallocation of staff between departments. Unpredicted factors may influence how the strategy is executed. Knowledge of potential moderating factors is essential to improve future staff contingency plans. To understand barriers and promoters of staff realloctation, this study explored the dynamics of reallocating staff from departments with low activity to clinical practice during the first wave of the COVID-19 pandemic at a 530-bed university hospital in the Capital Region of Denmark. MethodsWe used a mixed-methods explanatory design with sequential data collection and analysis. This paper primarily describes the qualitative part of the study, which consisted of six interviews with staff reallocated to clinical practice as part of the staff contingency plan, and seven interviews with leaders of departments that contributed with staff for reallocation. Data was analyzed using inductive content analysis.ResultsThe results showed that the execution of a staff contingency plan during a pandemic is influenced by a complex set of structural, perceptional, social, individual, and psychological moderating factors. Although staff felt obligated and motivated to cover shifts, their actual behavior and experience was influenced by factors such as uncertainty about tasks, family obligations, other work-related tasks, the contingency plan set-up, how the contingency plan, roles, and sense of urgency were interpreted by staff and leaders, and how the leaders prioritized tasks and staff time. Introduction to the unit and tasks, the feeling of being needed, voluntary participation, transparency, collegial sparring, and familiarity with the workplace were factors that promoted a positive experience.ConclusionsThis study identified a variety of complex moderating factors, which should be considered when hospital contingency plans are developed. The study highlights the importance of understanding how reallocated staff and leaders experience and make interpretations and adjustments to a given plan, as this may have great significance for how the contingency plan is put into practice. Future staff contingency plans should take these factors into consideration to make better use of human resources in times of a crisis and to improve staff’s experience with reallocation.

Factors preventing nosocomial outbreak following a single case of COVID-19 diagnosed during hospitalization: A retrospective review

Objective: Our hospital experienced a hospital shutdown and quarantine for two weeks after one case of COVID-19 was diagnosed during hospitalization. We analyzed the reopening process following hospital closure and possible factors that prevented hospital spread. Methods: We retrospectively reviewed the confirmed patient’s medical records and results of epidemiological survey available from the infection control team of our hospital. Results: A total of 117 hospital staff members were tested, 26 of whom were self-isolated. Of the 54 inpatients tested, 28 on the same floor and two close contacts in the endoscopic room were quarantined in a single room. Finally, all quarantined hospital staff, inpatients and outpatients were tested for COVID-19 on the 14th day of close contact. The results were all negative, and the hospital work completely resumed. Conclusion: Although closing and isolating the hospital appeared to have played a useful role in preventing the spread of COVID-19 inside the hospital and to the local community, it is still debated whether or not the duration of hospital closure or quarantine was appropriate. The lessons from the two-week hospital closure suggest that wearing a mask, hand hygiene and the ward environment are important factors in preventing nosocomial outbreaks of COVID-19.

The neonatal transfer process through the lens of neonatologists at public hospitals in South Africa

Background: Neonatal care is provided by various levels of healthcare facilities in South Africa. Intensive care for neonates is only provided at the higher levels, hence the need for transfers from lower-level to higher-level facilities (e.g. primary hospitals to tertiary hospitals) or across levels of facilities, particularly when life-threatening situations arise (e.g. cardiac deterioration, respiratory deterioration and desaturation).Aim: The aim of the study was to explore neonatologists’ views regarding the neonatal transfer process and to describe the preparedness of advanced life support (ALS) paramedics to undertake such transfers.Setting: The setting consisted of neonatologists from three provinces i.e. KwaZulu-Natal, Gauteng and Western cape.Method: A qualitative descriptive design was utilised in this study. Semistructured interviews were conducted on the public health hospitals in three provinces (N = 9; n = 3) with neonatologists (N = 7; n = 7) who were involved in the transfers of critically ill neonates. The process of thematic analysis was used.Results: The themes that emerged in this study were: an awareness of local contextual realities related to neonatal transfers, challenges evident within the context of neonatal transfers, decision-making around the transfer of ill neonates, ALS paramedic preparedness for transfers and good clinical governanceConclusion: The study found that there was a need to be aware of local contextual realities confronting neonatal transfers, a need for greater preparedness for paramedics to undertake these transfers, a need for a sound referral processes and a need for coordinated transfer effort between paramedics, hospital staff and transport team members for the successful transfer of critically ill neonates.Contribution: The findings highlight the challenges confronting the neonatal transfer process in South Africa through the lens of neonatologist at public hospitals. Hence, the study reinforces the preparedness and coordination of the transfer process, along with more efficient communication between paramedics, hospital staff and the transfer team.

ABO Blood Group Incompatibility Protects Against SARS-CoV-2 Transmission

ABO blood groups appear to be associated with the risk of SARS-CoV-2 infection, but the underlying mechanisms and their real importance remain unclear. Two hypotheses have been proposed: ABO compatibility-dependence (neutralization by anti-ABO antibodies) and ABO-dependent intrinsic susceptibility (spike protein attachment to histo-blood group glycans). We tested the first hypothesis through an anonymous questionnaire addressed to hospital staff members. We estimated symptomatic secondary attack rates (SAR) for 333 index cases according to spouse ABO blood group compatibility. Incompatibility was associated with a lower SAR (28% vs. 47%; OR 0.43, 95% CI 0.27–0.69), but no ABO dependence was detected in compatible situations. For the second hypothesis, we detected no binding of recombinant SARS-CoV-2 RBD to blood group-containing glycans. Thus, although no intrinsic differences in susceptibility according to ABO blood type were detected, ABO incompatibility strongly decreased the risk of COVID-19 transmission, suggesting that anti-ABO antibodies contribute to virus neutralization.

Examining pulmonary TB patient management and healthcare workers exposures in two public tertiary care hospitals, Bangladesh

Implementation of tuberculosis (TB) infection prevention and control (IPC) guidelines in public tertiary care general hospitals remain challenging due to limited evidence of pulmonary TB (PTB) patients’ duration of hospital stay and management. To fill this evidence gap, this study examined adult PTB patient management, healthcare workers’ (HCWs) exposures and IPC practices in two public tertiary care hospitals in Bangladesh.Between December 2017 and September 2019, a multidisciplinary team conducted structured observations, a hospital record review, and in-depth interviews with hospital staff from four adult medicine wards.Over 20 months, we identified 1,200 presumptive TB patients through the hospital record review, of whom 263 were confirmed PTB patients who stayed in the hospital, a median of 4.7 days without TB treatment and possibly contaminated the inpatients wards. Over 141 observation hours, we found a median of 3.35 occupants present per 10 m2 of floor space and recorded a total of 17,085 coughs and 316 sneezes: a median of 3.9 coughs or sneezes per 10 m2 per hour per ward. Only 8.4% of coughs and 21% of sneezes were covered by cloths, paper, tissues, or by hand. The HCWs reportedly could not isolate the TB patients due to limited resources and space and could not provide them with a mask. Further, patients and HCWs did not wear any respirators.The study identified that most TB patients stayed in the hospitals untreated for some duration of time. These PTB patients frequently coughed and sneezed without any facial protection that potentially contaminated the ward environment and put everyone, including the HCWs, at risk of TB infection. Interventions that target TB patients screening on admission, isolation of presumptive TB patients, respiratory hygiene, and HCWs’ use of personal protective equipment need to be enhanced and evaluated for acceptability, practicality and scale-up.