Using implementation science in youth mental health workforce development: Adapting to the COVID-19 pandemic in Australia

Aims: Globally, mental illness and substance use disorders are the leading cause of disability and disease burden for young people. Orygen is an Australian youth mental health organization with a mission to reduce the impact of mental ill-health on young people, families and society, and one of only a few known research and clinical centres with a dedicated Knowledge Translation division. This paper provides a case study of the workforce development team within Orygen Knowledge Translation, outlining how implementation science informs their work and how the division has adapted its model of service support in the face of COVID-19. Method(s): Process data on training and resources developed and delivered by the workforce development team at Orygen over the period 2017-2021 was collated and synthesized with team reflections about the adaptations made by team in response to the COVID-19 pandemic. Results and Conclusion(s): Since 2017, the team has delivered training to more than 4000 youth mental health workers across Australia, on the topics of trauma, psychosis, mood and anxiety disorders, brief interventions, cognition and other areas of youth mental health. The COVID-19 pandemic generated abrupt and dramatic changes to the delivery of workforce and service development initiatives in Australia due to significant restrictions to travel and in-person events. It also placed major delivery demands on youth mental health services. The COVID-19 pandemic facilitated profound and rapid changes to service delivery and development in Australian youth mental health. Implementation science offers flexible models to support a changing system.

A case series of diabetic ketoacidosis associated with SGLT2 inhibitors

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are increasingly initiated as treatment for type 2 diabetes due to favourable cardiorenal characteristics. However, studies have identified an increased risk of diabetic ketoacidosis (DKA). We carried out a retrospective, case-based study at East and North Herts NHS Trust between February 2018 and December 2020. Fifteen cases of SGLT2i associated DKA were identified in people with presumed type 2 diabetes;33.3% were classed as euglycaemic DKA with a blood glucose of <11mmol/L. All cases were associated with a significant precipitating factor including diarrhoea, vomiting, reduced oral intake and sepsis. One case was related to COVID-19. Two people were subsequently found to have raised islet autoantibodies suggesting type 1 diabetes or latent autoimmune diabetes in adults. It is important that awareness of SGLT2i associated DKA is raised among users and health care practitioners, including the recognition of euglycaemic DKA. Sick day rules should be emphasised and reiterated at clinical encounters. Non-specialists in primary care, oncology and in perioperative settings should be empowered to advocate for temporary withdrawal and there should be readier access to blood ketone monitoring when required. When SGLT2i associated DKA occurs, due consideration should be given to evaluate the diabetes classification and investigate the circumstances of the event. Copyright © 2023 John Wiley & Sons.Copyright © 2023 John Wiley & Sons, Ltd.

Impact of the COVID-19 pandemic on patients with osteogenesis imperfecta

OBJECTIVES: On March 11, 2020, the WHO classified COVID-19 as a global pandemic. Measures to quell the pandemic included limiting non-essential activities including clinic visits and procedures. It is unclear if individuals with OI had disruptions in their access to healthcare or medications, and if such disruptions affected patients' symptoms. METHOD(S): A REDCap survey was distributed through the OI Foundation on August 31. Surveys completed through September 11 by individuals with OI or their caregiver are included in this analysis. Participants were asked to compare their symptoms and access to healthcare during the first 4 months of the pandemic to the 4 months before the pandemic. RESULT(S): 85 surveys were completed, and 6 were partially completed. The median age of participants was 40 years;35% were children. 32% of participants self-identified as having severe OI. Although most reported no changes in bone pain or fractures, 46% reported they were less likely to seek emergency medical care to treat a fracture, while 33% reported they were more likely to treat fractures at home (Fig 1A). There were delays in accessing all services, with greatest delays accessing dentistry (74%) and aquatic therapy (84%) (Fig 1B). 36% of participants receiving bisphosphonate infusions had delayed infusions because of the pandemic (Fig 1C). Of note, 50% of planned surgeries were delayed. CONCLUSION(S): Although many individuals with OI and their caregivers reported delays in accessing bone-related services/clinics during this 4-month period, there was not a concomitant increase in reported symptoms. This may have related to shelter-in-place restrictions and decreased activity. Limitations of this study include small sample size and potential selection bias because responses were obtained only from OIF members. To address these limitations, we are distributing the survey through healthcare providers of individuals with OI across major regions of the US from a variety of practice types including endocrine, orthopedics and multidisciplinary clinics. Furthermore, as the COVID-19 pandemic continues, we hope that this survey will provide information to address what aspects of healthcare may be in greatest need, as well as the modality through which services may be met. (Figure Presented).

Providing culturally responsible health care to Pacific Islander communities: The creation of a cultural competency training for healthcare professionals

Cultural competency is the ability to respectfully engage, understand, and communicate through conscientious interaction, enabling effective work and meaningful relationships in cross-cultural situations. Cultural competency recognizes the importance for organizations of participants' diverse social and cultural values, beliefs, and behaviors, and has gained attention because it can bridge health perspectives, understanding, and respect between health professionals and patients. There remains a need for cultural competency in healthcare as disparities persist across the U.S. in racial and ethnic minority groups who experience worse health outcomes and lower healthcare quality than the general public. Therefore, a cultural competency training curriculum was created using various resources to improve interactions between Pacific Islander patients and healthcare professionals. This training helps to reduce racial/ethnic disparities in healthcare by encouraging mutual understanding and improving patient satisfaction, adherence to medical instructions, and overall health outcomes by highlighting patient-centered care as a result of utilizing components of cultural competency. To improve patient experiences in Hawai'i, healthcare professionals need the tools to better interact with patients from different cultures, such as Pacific Islanders. This training provides healthcare professionals with culturally-based content for improving cultural competence techniques for interacting with Pacific Island patients. This training was pilot tested with key stakeholders from community organizations and Cancer Center faculty/staff. Local health clinics, providers, and practices will have the opportunity to participate in this training through a Zoombased electronic training format and be provided with three continuing medical education credits. The initial delivery of the training was intended for in-person sessions;however, a virtual format was adapted due to the COVID-19 pandemic and subsequent social distancing regulations. Healthcare providers are provided pre-training resources, a pre- and post-test, and a course evaluation to determine the validity of training objectives. To date, two Federally Qualified Health Centers have been provided the training, n=60, as well as one Cancer Health Equity Partnerships' Scientific Workshop, n=40. For attendees, the analysis of correct responses from the pretest to post-test showed a significant improvement on 6 of the 12 questions. Respondents also agreed that the training resources aligned with the course objectives. Improved patient interactions from this training can help support better patient outcomes, adherence to medical advice regarding cancer screenings, and many other aspects of improving health equity for Pacific Islanders.

Low- and mid-level equine assisted services improved mood and state anxiety levels in health-care workers

The aim of this study was to measure the effect of equine assisted services (EAS) on mood and anxiety in health-care workers. While the emotional toll of the COVID-19 pandemic has been felt in every aspect of our society, health-care workers have been hit especially hard. A survey conducted by Mental Health America during June - September in 2020, found 93% of health-care workers were experiencing stress and 86% reported experiencing anxiety. There is research to support a wide range of interventions to address stress, low mood, and anxiety, including pharmaceuticals, physical exercise, and animal interaction. While several studies have shown an improvement in anxiety and mood after interaction with horses, few studies have included a physically active control group to consider the effect of exercise on results. In this study conducted in October 2021, participants were recruited from area hospitals and randomly assigned to a control group (30-min guided walk with no horse interaction, n = 17), a low level EAS group (30-min self-guided farm tour, n = 20), or a mid-level EAS group (30 min of grooming a horse, n = 19). Before the intervention, participants completed a demographic survey. Pre and post activity, participants completed the Brief Mood Introspection Scale (BMIS) and State Anxiety Inventory for AdultsTM that measured currentfeelings of mood and anxiety, respectively. Data were analyzed using the repeated measures one-way ANOVA procedure in SPSS. This study was approved by the MSU Human Research and Protection Program and the Institutional Animal Care and Use Committee. Fifty-six health-care workers participated in the study, with 32% having worked in health care for less than 5 years and 33.9% having worked in health care for over 20 years. All participants had a significant improvement in State-Anxiety scores after completing their group activity (P < 0.001), with no differences among groups. Similarly, all groups had an improved BMIS score (P < 0.001). However, there was significantly greater improvement in BMIS scores in the mid-level EAS (P < 0.01) when compared with the control group. While all participants in this study improved both their current feelings of anxiety and mood after completing an activity on the farm, there was a greater improvement in mood in those individuals who spent 30 min grooming a horse when compared with the walk group without horse interaction. The results from this study provide further support for the impact of equine assisted services as a means of improving mood.Copyright © 2023

A Qualitative Analysis of Physician, Staff, and Patient Perspectives During the Discharge Process for Vascular Patients

Objectives: Evidence demonstrates that when hospitals focus on the discharge process patient safety improves and overall costs decline. Hospital discharge requires care coordination of multiple disciplines, often leading to fragmented care, and adverse outcomes after discharge include emergency department visits and hospital readmissions. The Re-Engineered Discharge (RED) process was developed as an evidence-based strategy to improve the hospital discharge. We evaluated perspectives and priorities of physicians, health care workers, and patients involved in the vascular discharge process using RED as a framework. Method(s): A single-center qualitative analysis using a semi-structured focus groups and an interview guide based on the RED process. Focus groups were Zoom platform recorded, transcribed into text files, independently coded, and analyzed with Dedoose qualitative software using a directed content analysis approach. Thematic concepts were created, and comparisons between groups were analyzed by coding frequency. Researchers independently thematically coded each transcript;prior to analysis, all redundancy of codes was resolved;and all team members agreed on text categorization and coding frequency. Result(s): Eight focus groups with 38 participants were performed. Participants included: physicians (n = 13), nursing and ancillary staff (n = 19), and patients/caregivers (n = 6). Transcript analyses revealed facilitators and barriers to discharge. Overarching themes identified from the qualitative analysis frequencies are displayed by stakeholder role (Fig 1). Themes identified with the greatest coding frequencies included helpfulness of discharge instructions, patient health literacy, patient medical complexity, poor interdisciplinary team communication, time constraints during discharge, technology literacy of patients, barriers to obtaining medications for patients, barriers to organizing outpatient services for health care workers, barriers for patients to obtain help after discharge, and the impact of COVID-19. Conclusion(s): These findings identify the need to strengthen efforts to overcome stakeholder barriers to improve patient safety at the interface of the hospital to create a well-organized discharge. Physicians were most concerned with low patient health literacy, patient understanding of discharge instructions, organizing outpatient services, and overall patient medical complexity hindering a smooth discharge. Health care staff identified time constraints, obtaining medications and, and inter-team communication as their greatest obstacles to an organized discharge. Patients found the complexity and amount of discharge instructions, the impact of COVID-19 on support systems, and technology utilization after discharge most challenging. Modifications to address individual stakeholder barriers within the discharge process are needed to develop a national standardized discharge specific for vascular surgery patients to improve patient safety and satisfaction. [Formula presented]Copyright © 2023

COVID-19 Vaccine: Knowledge and Acceptance among Obstetric Population in Garhwal Region of Uttarakhand

Background: Coronavirus disease-2019 (COVID-19) poses expectant mothers to a higher risk of serious complications and mortality. Following a risk-benefit review, a number of governmental and professional bodies from across the globe recently approved the COVID-19 vaccination during pregnancy. Aim(s): This study aimed to investigate knowledge, actual acceptance, and concerns about the COVID-19 vaccine among the obstetric population. Material(s) and Method(s): Participants were selected from among the expecting women who came for antenatal checkup during the study period (October 1, 2021-November 30, 2021). About 150 pregnant women who met the inclusion criteria and consented were recruited into the study. Data related to socio-demographic and clinical characteristics as well as knowledge, actual acceptance, and concerns about COVID-19 vaccine were collected through in-person interviews using a prestructured questionnaire. The SPSS version 23 was used to analyze data. The association between the attitude (acceptance and hesitance) of participants toward the COVID-19 vaccine and their sociodemographic and clinical profile was found by Fisher's exact test. Result(s): The actual acceptance of the COVID-19 vaccine among expecting women was 52.0%. The primary motive for accepting COVID-19 immunization was to protect the fetus, followed by the protection of one's own health. A significant association was found between COVID-19 vaccine acceptance and the level of education, socio-economic status, and presence of comorbidities. The leading causes for vaccine reluctance were concerns about the efficacy and safety of the vaccines and lack of awareness about their usage during pregnancy. Conclusion(s): Multifaceted activities are required to promote the effectiveness and safety profile of the COVID-19 vaccine as well as disseminate knowledge about its usage during pregnancy. Clinical significance: Unlike numerous other studies that have investigated the accepting attitude only, the present one has investigated the actual COVID-19 vaccine uptake among the obstetric population.Copyright © The Author(s).

Immersive Technologies - The future for tracheostomy education?

Introduction: The need for standardised education on tracheostomy care is well recognised.1 Staff frequently report a lack of confidence in caring for those with tracheostomies, as well as the management of adverse events as they occur.2 Over the past decade, healthcare providers have developed strategies to educate staff, however, the covid-19 pandemic has severely hampered the ability to provide this necessary training due to restrictions on access to training rooms, the need for social distancing and the significant clinical demands placed on both trainers and trainees.3 The potential for immersive technologies to augment healthcare training is gaining interest exponentially.4 However, its effectiveness is yet to be clearly understood and as such it is not yet common within healthcare education.5 Based on the above, we aimed to explore the potential of these immersive technologies to overcome the current challenges of tracheostomy education, and to develop future strategies to use immersive technology in healthcare education. Method(s): We received a 400,000 grant from Cardiff Capital Region (CCR) to undertake a rapid innovation project overseen by the SBRI centre of excellence. The project consisted of 3 main phases: 1) feasibility;2) development;and 3) testing. The project was officially launched in April 2021 and lasted 12 months. Project governance was provided via the SBRI for clinical excellence, a project board with representation from Welsh Government, Cardiff University and Cardiff and Vale UHB, and a project team with clinical expertise in both the delivery of tracheostomy education and the provision of simulation training in healthcare. Result(s): Phase 1: During phase one 4 industries were successful and received up to 30,000 to explore the feasibility of immersive technology to support tracheostomy education. The industries were Rescape, TruCorp, Aspire2Be and Nudge Reality. During the feasibility phase all industries focused on the emergency management process utilising existing NHS Wales tracheostomy education resources and the national tracheostomy safety programme. Phase 2: For phase 2, Rescape and Nudge Reality were chosen to develop the technology. These industries continued to work in conjunction with the project team to capture the core elements of tracheostomy care, including multi-user emergency management scenarios. Additional content was also added for bronchoscopy and insertion of intercostal drains. Phase 3: Testing of both solutions was undertaken over an 8-week period, across 6 Health Boards in NHS Wales. The results of the testing will be analysed and available for presentation in due course. Provision findings demonstrate good face and content validity with high levels of user satisfaction. Discussion / Conclusion(s): The provision of essential tracheostomy education has been severely affected by the covid-19 pandemic. Evolving immersive technologies have the potential to overcome these challenges and improve the effectiveness and efficiency of education packages in tracheostomy care and wider. Through this CCR grant, in conjunction with industry, we have developed two solutions with the potential for widescale procurement and future research on the use of immersive technologies within healthcare.

Ethnic, racial and migrant inequalities in respiratory health

Disparities in the incidence, prevalence, and morbidity and mortality rates of many respiratory diseases are evident among ethnic groups. Biological, cultural and environmental factors related to ethnicity can all contribute to the differences in respiratory health observed among ethnic minority groups, but the inequalities observed are most commonly due to lower socioeconomic position. People who migrate within a country or across an international border may experience an improvement in respiratory health associated with improvements in socioeconomic position. However, migrants may also experience worse health outcomes in destination countries, as they are faced by barriers in language and culture, discrimination, exclusion and limited access to health services. While some high-quality studies investigating ethnicity and respiratory health are available, further research into ethnic differences is needed. Improving the recording of ethnicity in health records, addressing barriers to accessing respiratory healthcare and improving cultural literacy more generally are some of the ways that inequalities can be tackled.Copyright © ERS 2023.

International Residents' Perspectives on Education and Challenges in Microsurgery Training

Objective Microsurgery remains an integral component of the surgical skillset and is essential for a diversity of reconstructive procedures. The apprenticeship also requires overcoming a steep learning curve, among many challenges. The method of microsurgical training differs depending on the countries' regions and resources of their health care system. Methods The Journal of Hand and Microsurgery leadership held an international webinar on June 19, 2021, consisting of a panel of residents from 10 countries and moderated by eminent panelists. This inaugural event aimed to share different experiences of microsurgery training on a global scale, identifying challenges to accessing and delivering training. Results Residents shared various structures and modes of microsurgical education worldwide. Areas of discussion also included microsurgical laboratory training, simulation training, knowledge sharing, burnout among trainees, and challenges for female residents in microsurgical training. Conclusion Microsurgical proficiency is attained through deliberate and continued practice, and there is a strong emphasis globally on training and guidance. However, much remains to be done to improve microsurgical training and start acting on the various challenges raised by residents.Copyright © 2022. Society of Indian Hand & Microsurgeons. All rights reserved.

Septic cavernous sinus thrombosis in a patient with COVID-19.

The cavernous sinus is one of the dural venous sinuses which plays an important role in venous outflow from the brain and eye sockets and in the regulation of intracranial circulation. We report a case of septic cavernous sinus thrombosis in a female patient with COVID-19. The disease often results in alterations of blood rheology, thrombosis in different organs, and septic complications. This article aims to raise awareness of healthcare professionals about the characteristics of COVID-19 that might cause septic cavernous sinus thrombosis in patients with severe comorbidities. Laboratory testing revealed severe comorbidities, including diabetes mellitus and liver cirrhosis caused by hepatitis C. They manifested with an impaired protein production in the liver and coagulation disorders. Systemic effects of SARS-CoV-2 on the vascular endothelium aggravated preexisting coagulation disorders and led to hemorrhage into retrobulbar tissue and clinical signs of septic cavernous sinus thrombosis, including swelling of the eyelids, bilateral exophthalmos, and ophthalmoplegia, followed by necrosis of the facial skin.Copyright © 2022, Dynasty Publishing House. All rights reserved.

Effect of COVID-19 pandemic on sleep quality of frontline healthcare workers

Background: The 2019 coronavirus disease (COVID-19) outbreak, which was brought on by the SARS-CoV-2 novel coronavirus, has had a significant negative influence on our environment and exposed health-care personnel to a new level of risk. Very few studies have addressed the disturbances in the sleep quality of healthcare workers during COVID-19 pandemic. Aim and Objectives: The primary objective of the study was to examine the sleep quality of frontline healthcare workers during COVID-19 pandemic in a tertiary care center in northern Kerala. Material(s) and Method(s): Healthcare workers belonging to a tertiary care center were invited to participate in the study. An online questionnaire including sociodemographics, Pittsburgh sleep quality index, and Insomnia severity index was used to evaluate sleep disturbances in healthcare workers. Univariate and bivariate analysis of the results were done to identify the predictors of poor sleep quality. Result(s): A total of 250 frontline healthcare workers were enrolled in the study, out of which 243 participants provided usable responses. About 27.6% of health workers showed features of poor sleep quality. The prevalence rate of poor sleep quality was highest among nurses, 55.2% followed by doctors and ambulance drivers, 22.4% and 11.9%, respectively. About 17.7% of the study population had subthreshold insomnia and 1.2% had clinical insomnia of moderate intensity. Conclusion(s): The prevalence of poor sleep quality is high among healthcare workers confronting COVID pandemic. This study emphasizes the need to implement specific protective measures for maintaining the sleep quality and decreasing stress among frontline health care workers during pandemics.Copyright © 2023, Mr Bhawani Singh. All rights reserved.

Mental distress among healthcare workers due to COVID-19 during second wave in a tertiary care center of South Karnataka: A cross-sectional study

Background: Healthcare workers (HCWs) in India are facing physical and psychological pressure. The pandemic has significant psychological impacts. Hence, we wanted to assess the mental stress and social stress among HCWs during the second wave of COVID-19. Aim and Objectives: Assessment of the mental distress among HCWs of tertiary care level institution during second wave of COVID-19 with the following objectives: (1) To know the sociodemographic characteristics of the HCWs of tertiary care center and (2) to assess the psychological stress among healthcare workers of a tertiary health center. Material(s) and Method(s): It is a cross-sectional and observational study conducted in hospital setting, in a tertiary care setting. Data were collected from 196 HCWs of the institute. Institutional ethical clearance was taken before the study. Structured questionnaire included sociodemographic variables, work-related variables, and variables to assess social stress. We used hospital anxiety and depression scoring questionnaire to assess anxiety and depression. Data were collected through personal interviews and online through Google forms after taking informed consent. Descriptive statistics and Chi-square tests are used analyzed using Statistical Package for the Social Sciences Version 21 for Statistical analysis. Result(s): A total of 196 HCWs, 121 doctors, 74 nursing staff, and one ward staff participated in the study. Nursing staff were at higher risk for anxiety and depression, that is, 29% and 25% than others. Females were slightly more anxious (29%) and depressed (17%) than males. HCWs who are Muslim by religion were at more mental distress. Media exposure of more than 3 h had increased risk of mental distress. HCWs with other frontline COVID warrior as a partner were both anxious (40%) and depressed (20%). Anxiety (35%) was more among those who's family members got COVID positive. About 25% of them faced social stigma, 55% of them faced issue of isolation with in the community, and 14% of them faced acts of violence which is unacceptable. Conclusion(s): Although its second wave HCWs are still having psychological distress which needs to be addressed. Social stress that they are facing is significant and is associated with higher anxiety and depression, which has to be taken seriously.Copyright © 2023, Mr Bhawani Singh. All rights reserved.

Preoperative evaluation and timing of surgery for adult patients after covid-19 infection: Recommendations of peking union medical college hospital (2023).

With the adjustment of China's epidemic prevention and control guidelines regarding coronavirus disease of 2019(COVID-19), the preoperative evaluation and timing of surgery for patients after COVID-19 infection have become the focus of attention for both healthcare workers and patients. Based on the latest study and related clinical experience, Peking Union Medical College Hospital (PUMCH) has therefore compiled this multidisciplinary, evidence-based recommendation for concise, individualized, and practical preoperative evaluation and timing of surgery for patients after COVID-19 infection. The recommendations emphasize patients' COVID-19 infection history, the severity of symptoms, and medical/physiologic recovery status during preoperative evaluation. The determination of appropriate length of time between recovery from COVID-19 and surgery/procedure should take into account of patients' underlying health conditions, the severity of the COVID-19 infection course, and the types of surgery and anesthesia scheduled, to minimize postoperative complications. The recommendations are intended to aid healthcare workers in evaluating these patients, scheduling them for the optimal timing of surgery, and optimizing perioperative management and postoperative recovery.Copyright © 2023, Peking Union Medical College Hospital. All rights reserved.

Identification of Risk Factors for Nasal Colonization of Methicillin-resistant Staphylococcus aureus and Vancomycin-resistant Staphylococcus aureus in Health Workers at a Tertiary Hospital, Indonesia

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) and Vancomycin-resistant S. aureus (VRSA) frequently cause nosocomial infections yearly. During the COVID-19 pandemic, the potential for excessive use of antibiotics is a global threat to the increasing incidence of multiresistant bacteria. AIM: This study aimed to determine MRSA and VRSA colonization and identify factors associated with the risk of MRSA and VRSA nasal colonization in health workers at Dr. Soemarno Sosroatmodjo General Hospital, Kuala Kapuas, as one of the type C hospitals in Indonesia. METHOD(S): This cross-sectional analytic study at Dr. Soemarno Sosroatmodjo General Hospital, a tertiary hospital in Indonesia. A 128 health workers' subjects had undergone nasal swab screening for MRSA and VRSA colonization examinations. Then, they were asked to complete a questionnaire concerning the risk factors of MRSA and VRSA infections. RESULT(S): Nasal swab results obtained as many as 30 (23.5%) MRSA positive subjects and 6 (4.7%) subjects with positive VRSA. The most common risk factors that led to MRSA colonization included a history of positive MRSA in the previous hospital (60%), a history of ear, nose, and throat infection (41.7%), and did not do hand rub/handwash (36.7%). In comparison, the most risk factors for VRSA colonization were having pigs farm at home (33.3%), a history of positive MRSA in the previous hospital (20%), and a history of hospitalization in the past 6-12 months (16.7%). The results of multivariate analysis showed the most powerful and statistically significant risk factors in influencing nasal MRSA colonization were a history of positive MRSA in the previous hospital (OR 13.69, 95% confidence intervals [CI]: 1.34-140.25, p = 0.028) and did not do hand rub/handwash (OR 2.95, 95% CI: 1.167-7.49, p = 0.023). Meanwhile, marital status (OR 0.160, 95% CI: 0.02-1.06), p = 0.058) and home care service (OR 6.10, 95% CI: 0.79-46.96, p = 0.082) were the strongest risk factors for nasal colonization of VRSA but not statistically significant. CONCLUSION(S): As many as, 23.5% and 4.7% of healthcare workers' subjects were found with nasal colonization of MRSA and VRSA, respectively. Accordingly, strict policies are needed to minimize the transmission of these organisms from the hospital setting to the community.Copyright © 2023 Siti Nur Rohmah, Rizka Humardewayanti Asdie, Ida Yosopa, Daya Daryadijaya.