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1.
Nurs Leadersh (Tor Ont) ; 34(2): 16-20, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34197288

RESUMO

In their paper, Stelnicki and Carleton (2021) highlight both the findings of their 2019 survey of nurses' mental health (Stelnicki et al. 2020) and more recent literature published during the COVID-19 pandemic. This response outlines the role of nursing leaders in enabling the mental health of nurses in a mental health and addiction setting, particularly during the COVID-19 pandemic.


Assuntos
Recursos Humanos de Enfermagem no Hospital/psicologia , Equipe de Assistência ao Paciente/organização & administração , Enfermagem Psiquiátrica/organização & administração , Resiliência Psicológica , COVID-19/epidemiologia , COVID-19/prevenção & controle , Hospitais Psiquiátricos/organização & administração , Humanos , Controle de Infecções/normas , Liderança , Ontário/epidemiologia , Pandemias , SARS-CoV-2
2.
Artigo em Inglês | MEDLINE | ID: mdl-34206845

RESUMO

BACKGROUND: Our objective was to examine the temporal relationship between COVID-19 infections among prison staff, incarcerated individuals, and the general population in the county where the prison is located among federal prisons in the United States. METHODS: We employed population-standardized regressions with fixed effects for prisons to predict the number of active cases of COVID-19 among incarcerated persons using data from the Federal Bureau of Prisons (BOP) for the months of March to December in 2020 for 63 prisons. RESULTS: There is a significant relationship between the COVID-19 prevalence among staff, and through them, the larger community, and COVID-19 prevalence among incarcerated persons in the US federal prison system. When staff rates are low or at zero, COVID-19 incidence in the larger community continues to have an association with COVID-19 prevalence among incarcerated persons, suggesting possible pre-symptomatic and asymptomatic transmission by staff. Masking policies slightly reduced COVID-19 prevalence among incarcerated persons, though the association between infections among staff, the community, and incarcerated persons remained significant and strong. CONCLUSION: The relationship between COVID-19 infections among staff and incarcerated persons shows that staff is vital to infection control, and correctional administrators should also focus infection containment efforts on staff, in addition to incarcerated persons.


Assuntos
COVID-19 , Prisioneiros , Humanos , Controle de Infecções , Prisões , SARS-CoV-2 , Estados Unidos/epidemiologia
3.
BMC Fam Pract ; 22(1): 146, 2021 07 03.
Artigo em Inglês | MEDLINE | ID: mdl-34217208

RESUMO

BACKGROUND: Early in the COVID-19 pandemic, general practices were asked to expand triage and to reduce unnecessary face-to-face contact by prioritizing other consultation modes, e.g., online messaging, video, or telephone. The current study explores the potential barriers and facilitators general practitioners experienced to expanding triage systems and their attitudes towards triage during the COVID-19 pandemic. METHOD: A mixed-method study design was used in which a quantitative online survey was conducted along with qualitative interviews to gain a more nuanced appreciation for practitioners' experiences in the United Kingdom. The survey items were informed by the Theoretical Domains Framework so they would capture 14 behavioral factors that may influence whether practitioners use triage systems. Items were responded to using seven-point Likert scales. A median score was calculated for each item. The responses of participants identifying as part-owners and non-owners (i.e., "partner" vs. "non-partner" practitioners) were compared. The semi-structured interviews were conducted remotely and examined using Braun and Clark's thematic analysis. RESULTS: The survey was completed by 204 participants (66% Female). Most participants (83%) reported triaging patients. The items with the highest median scores captured the 'Knowledge,' 'Skills,' 'Social/Professional role and identity,' and 'Beliefs about capabilities' domains. The items with the lowest median scores captured the 'Beliefs about consequences,' 'Goals,' and 'Emotions' domains. For 14 of the 17 items, partner scores were higher than non-partner scores. All the qualitative interview participants relied on a phone triage system. Six broad themes were discovered: patient accessibility, confusions around what triage is, uncertainty and risk, relationships between service providers, job satisfaction, and the potential for total digital triage. Suggestions arose to optimize triage, such as ensuring there is sufficient time to conduct triage accurately and providing practical training to use triage efficiently. CONCLUSIONS: Many general practitioners are engaging with expanded triage systems, though more support is needed to achieve total triage across practices. Non-partner practitioners likely require more support to use the triage systems that practices take up. Additionally, practical support should be made available to help all practitioners manage the new risks and uncertainties they are likely to experience during non-face-to-face consultations.


Assuntos
COVID-19 , Medicina Geral , Clínicos Gerais , Consulta Remota , Triagem , Atitude do Pessoal de Saúde , COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/terapia , Competência Clínica , Inglaterra/epidemiologia , Feminino , Medicina Geral/organização & administração , Medicina Geral/normas , Medicina Geral/tendências , Clínicos Gerais/psicologia , Clínicos Gerais/normas , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Controle de Infecções/métodos , Controle de Infecções/normas , Masculino , Padrões de Prática Médica/ética , Padrões de Prática Médica/tendências , Consulta Remota/ética , Consulta Remota/métodos , Gestão de Riscos/tendências , SARS-CoV-2 , Triagem/ética , Triagem/métodos , Triagem/organização & administração , Triagem/normas
4.
Prev Chronic Dis ; 18: E65, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34197284

RESUMO

INTRODUCTION: Telehealth plays a role in the continuum of care, especially for older adults during the COVID-19 pandemic. Our objective was to examine factors associated with the accessibility of telehealth services during the COVID-19 pandemic among older adults. METHODS: We analyzed the nationally representative Medicare Current Beneficiary Survey COVID-19 Rapid Response Supplement Questionnaire of beneficiaries aged 65 years or older. Two weighted multivariable logistic regression models were used to examine associations between usual providers who offered telehealth 1) during the COVID-19 pandemic and 2) to replace a regularly scheduled appointment. We examined factors including sociodemographic characteristics, comorbidities, and digital access and literacy. RESULTS: Of the beneficiaries (n = 6,172, weighted n = 32.4 million), 81.2% reported that their usual providers offered telehealth during the COVID-19 pandemic. Among those offered telehealth services, 56.8% reported that their usual providers offered telehealth to replace a regularly scheduled appointment. Disparities in accessibility of telehealth services by sex, residing area (metropolitan vs nonmetropolitan), income level, and US Census region were observed. Beneficiaries who reported having internet access (vs no access) (OR, 1.75, P < .001) and who reported ever having participated in video, voice, or conference calls over the internet before (vs not) (OR, 2.18, P < .001) were more likely to report having access to telehealth. Non-Hispanic Black beneficiaries (versus White) (OR, 1.57, P = .007) and beneficiaries with comorbidities (vs none) (eg, 2 or 3 comorbidities, OR, 1.25, 95% P = .044) were more likely to have their usual provider offer telehealth to replace a regularly scheduled appointment. CONCLUSION: Although accessibility of telehealth has increased, inequities raise concern. Educational outreach and training, such as installing and launching an online web conferencing platform, should be considered for improving accessibility of telehealth to vulnerable populations beyond the COVID-19 pandemic.


Assuntos
COVID-19 , Acesso aos Serviços de Saúde , Disparidades em Assistência à Saúde , Controle de Infecções/métodos , Medicare/estatística & dados numéricos , Telemedicina , Idoso , COVID-19/epidemiologia , COVID-19/prevenção & controle , Comorbidade , Estudos Transversais , Demografia , Feminino , Acesso aos Serviços de Saúde/normas , Acesso aos Serviços de Saúde/estatística & dados numéricos , Disparidades em Assistência à Saúde/etnologia , Disparidades em Assistência à Saúde/organização & administração , Humanos , Acesso à Internet/estatística & dados numéricos , Masculino , Determinação de Necessidades de Cuidados de Saúde , SARS-CoV-2 , Fatores Socioeconômicos , Telemedicina/métodos , Telemedicina/organização & administração , Telemedicina/estatística & dados numéricos , Estados Unidos/epidemiologia
5.
Ann Glob Health ; 87(1): 51, 2021 06 24.
Artigo em Inglês | MEDLINE | ID: mdl-34221904

RESUMO

Background: Nurses working in treating patients with COVID-19 are exposed to various stressors, such as fear of COVID-19, stress, and high workload, leading to burnout. Objectives: This study aimed to identify the level of burnout and its predictors in nurses working in hospitals for COVID-19 patients. Methods: Participants in this study were nurses working in 11 hospitals for COVID-19 patients in the Fars province of Iran. The Maslach burnout and the UK Health and Safety stress questionnaires were used to assess burnout and stress, respectively. Analysis, using multiple regression in the SPSS21 software, aimed to identify the factors affecting burnout. Findings: The mean level of burnout in the nurses at the COVID-19 hospitals was 57 out of 120, and burnout was affected by workload (ß = 0.69, p < 0.001), job stress (ß = 0.25, p < 0.001) and inadequate hospital resources for the prevention of COVID-19 (ß = -0.16, p < 0.001). These three variables explained 87% of the variance in burnout. Conclusions: The burnout of nurses directly exposed to COVID-19 patients is more than nurses in other wards, and workload is the most significant cause of burnout in them. Therefore, necessary measures such as hiring more nurses, reducing working hours and increasing rest periods are necessary to reduce workload. In addition, the job stress of these nurses should be managed and controlled, and the hospital resources needed to prevent this disease should be provided.


Assuntos
Esgotamento Profissional , COVID-19 , Enfermeiras e Enfermeiros , Estresse Ocupacional , Tolerância ao Trabalho Programado/psicologia , Carga de Trabalho , Adulto , Esgotamento Profissional/epidemiologia , Esgotamento Profissional/prevenção & controle , Esgotamento Profissional/psicologia , COVID-19/epidemiologia , COVID-19/enfermagem , COVID-19/psicologia , Medo/psicologia , Feminino , Necessidades e Demandas de Serviços de Saúde , Humanos , Controle de Infecções/métodos , Irã (Geográfico)/epidemiologia , Masculino , Enfermeiras e Enfermeiros/psicologia , Enfermeiras e Enfermeiros/provisão & distribuição , Estresse Ocupacional/complicações , Estresse Ocupacional/prevenção & controle , SARS-CoV-2 , Carga de Trabalho/psicologia , Carga de Trabalho/normas , Carga de Trabalho/estatística & dados numéricos
6.
Ann Glob Health ; 87(1): 56, 2021 06 25.
Artigo em Inglês | MEDLINE | ID: mdl-34221909

RESUMO

Background: The adherence of medical laboratory technicians (MLT) to infection control guidelines is essential for reducing the risk of exposure to infectious agents. This study explored the adherence of MLT towards infection control practices during the COVID-19 pandemic. Method: The study population consisted of MLT (n = 444) who worked in private and government health sectors in Jordan. A self-reported survey was used to collect data from participants. Findings: More than 87% of the participants reported adherence to hand-washing guidelines and using personal protective equipment (PPE) when interacting with patients (74.5%), and handling clinical samples (70.0%). Besides, 88.1%, 48.2%, and 7.7% reported wearing of lab coats, face masks, and goggles, at all times, respectively. The majority reported increased adherence to infection control practices during the COVID-19 pandemic. This includes increased PPE use at the workplace (94.2%), increased frequency of disinfection of laboratory surfaces (92.4%) and laboratory equipment (86.7%), and increased frequency of handwashing/use of antiseptics (94.6%). Having a graduate degree was significantly associated with increased adherence of participants to the daily use of goggles/eye protection (p = 0.002), and the use of PPE while handling clinical samples (p = 0.011). Having work experience of >10 years was associated with increased adherence to the use of PPE while handling clinical samples (p = 0.001). Conclusion: MLT reported very good adherence with most assessed infection control practices. In addition, they reported increased conformity with infection control guidelines during the COVID-19 pandemic.


Assuntos
COVID-19 , Fidelidade a Diretrizes , Controle de Infecções , Laboratórios , Pessoal de Laboratório Médico , Equipamento de Proteção Individual , Adulto , COVID-19/epidemiologia , COVID-19/prevenção & controle , Feminino , Fidelidade a Diretrizes/normas , Fidelidade a Diretrizes/estatística & dados numéricos , Desinfecção das Mãos/métodos , Desinfecção das Mãos/normas , Pesquisas sobre Serviços de Saúde , Humanos , Controle de Infecções/instrumentação , Controle de Infecções/métodos , Controle de Infecções/normas , Jordânia/epidemiologia , Laboratórios/organização & administração , Laboratórios/normas , Masculino , Pessoal de Laboratório Médico/normas , Pessoal de Laboratório Médico/estatística & dados numéricos , Equipamento de Proteção Individual/estatística & dados numéricos , Equipamento de Proteção Individual/provisão & distribuição , Guias de Prática Clínica como Assunto , SARS-CoV-2 , Autorrelato
7.
Nurs Leadersh (Tor Ont) ; 34(2): 16-20, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: covidwho-1291998

RESUMO

In their paper, Stelnicki and Carleton (2021) highlight both the findings of their 2019 survey of nurses' mental health (Stelnicki et al. 2020) and more recent literature published during the COVID-19 pandemic. This response outlines the role of nursing leaders in enabling the mental health of nurses in a mental health and addiction setting, particularly during the COVID-19 pandemic.


Assuntos
Recursos Humanos de Enfermagem no Hospital/psicologia , Equipe de Assistência ao Paciente/organização & administração , Enfermagem Psiquiátrica/organização & administração , Resiliência Psicológica , COVID-19/epidemiologia , COVID-19/prevenção & controle , Hospitais Psiquiátricos/organização & administração , Humanos , Controle de Infecções/normas , Liderança , Ontário/epidemiologia , Pandemias , SARS-CoV-2
8.
Artigo em Inglês | MEDLINE | ID: covidwho-1288861

RESUMO

BACKGROUND: Our objective was to examine the temporal relationship between COVID-19 infections among prison staff, incarcerated individuals, and the general population in the county where the prison is located among federal prisons in the United States. METHODS: We employed population-standardized regressions with fixed effects for prisons to predict the number of active cases of COVID-19 among incarcerated persons using data from the Federal Bureau of Prisons (BOP) for the months of March to December in 2020 for 63 prisons. RESULTS: There is a significant relationship between the COVID-19 prevalence among staff, and through them, the larger community, and COVID-19 prevalence among incarcerated persons in the US federal prison system. When staff rates are low or at zero, COVID-19 incidence in the larger community continues to have an association with COVID-19 prevalence among incarcerated persons, suggesting possible pre-symptomatic and asymptomatic transmission by staff. Masking policies slightly reduced COVID-19 prevalence among incarcerated persons, though the association between infections among staff, the community, and incarcerated persons remained significant and strong. CONCLUSION: The relationship between COVID-19 infections among staff and incarcerated persons shows that staff is vital to infection control, and correctional administrators should also focus infection containment efforts on staff, in addition to incarcerated persons.


Assuntos
COVID-19 , Prisioneiros , Humanos , Controle de Infecções , Prisões , SARS-CoV-2 , Estados Unidos/epidemiologia
9.
JAMA Netw Open ; 4(7): e2115699, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34228126

RESUMO

Importance: Identifying health care settings and professionals at increased risk of SARS-CoV-2 infection is crucial to defining appropriate strategies, resource allocation, and protocols to protect health care workers (HCWs) and patients. Moreover, such information is crucial to decrease the risk that HCWs and health care facilities become amplifiers for SARS-CoV-2 transmission in the community. Objective: To assess the association of different health care professional categories and operational units, including in-hospital wards, outpatient facilities, and territorial care departments, with seroprevalence and odds of SARS-CoV-2 infection. Design, Setting, and Participants: This cross-sectional study was conducted using IgG serological tests collected from April 1 through May 26, 2020, in the Lombardy region in Italy. Voluntary serological screening was offered to all clinical and nonclinical staff providing any health care services or support to health care services in the region. Data were analyzed from June 2020 through April 2021. Exposures: Employment in the health care sector. Main Outcomes and Measures: Seroprevalence of positive IgG antibody tests for SARS-CoV-2 was collected, and odds ratios of experiencing infection were calculated. Results: A total of 140 782 professionals employed in the health sector were invited to participate in IgG serological screening, among whom 82 961 individuals (59.0% response rate) were tested for SARS-CoV-2 antibodies, with median (interquartile range [IQR]; range) age, 50 (40-56; 19-83) years and 59 839 (72.1%) women. Among these individuals, 10 115 HCWs (12.2%; 95% CI, 12.0%-12.4%) had positive results (median [IQR; range] age, 50 [39-55; 20-80] years; 7298 [72.2%] women). Statistically significantly higher odds of infection were found among health assistants (adjusted odds ratio [aOR], 1.48; 95% CI, 1.33-1.65) and nurses (aOR, 1.28; 95% CI, 1.17-1.41) compared with administrative staff and among workers employed in internal medicine (aOR, 2.24; 95% CI, 1.87-2.68), palliative care (aOR, 1.84; 95% CI, 1.38-2.44), rehabilitation (aOR, 1.59; 95% CI, 1.33-1.91), and emergency departments (aOR, 1.56; 95% CI, 1.29-1.89) compared with those working as telephone operators. Statistically significantly lower odds of infection were found among individuals working in forensic medicine (aOR, 0.40; 95% CI, 0.19-0.88), histology and anatomical pathology (aOR, 0.71; 95% CI, 0.52-0.97), and medical device sterilization (aOR, 0.54; 95% CI, 0.35-0.84) compared with those working as telephone operators. The odds of infection for physicians and laboratory personnel were not statistically significantly different from those found among administrative staff. The odds of infection for workers employed in intensive care units and infectious disease wards were not statistically significantly different from those of telephone operators. Conclusions and Relevance: These findings suggest that professionals partially accustomed to managing infectious diseases had higher odds of SARS-CoV-2 infection. The findings further suggest that adequate organization of clinical wards and personnel, appropriate personal protective equipment supply, and training of all workers directly and repeatedly exposed to patients with clinical or subclinical COVID-19 should be prioritized to decrease the risk of infection in health care settings.


Assuntos
COVID-19/epidemiologia , Pessoal de Saúde , Exposição Ocupacional/efeitos adversos , Pandemias , Adulto , COVID-19/sangue , COVID-19/virologia , Estudos Transversais , Feminino , Humanos , Imunoglobulina G/sangue , Controle de Infecções , Itália , Masculino , Pessoa de Meia-Idade , Equipamento de Proteção Individual , Fatores de Risco , SARS-CoV-2 , Estudos Soroepidemiológicos
10.
Antimicrob Resist Infect Control ; 10(1): 102, 2021 07 02.
Artigo em Inglês | MEDLINE | ID: mdl-34215330

RESUMO

INTRODUCTION: In late 2019, a novel coronavirus was detected in China. Supported by its respiratory transmissibility, even by people infected without symptomatic disease, this coronavirus soon began to rapidly spread worldwide. BACKGROUND: Many countries have implemented different infection control and containment strategies due to ongoing community transmission. In this context, contact tracing as well as adequate testing and consequent quarantining of high-risk contacts play leading roles in containing the virus by interrupting infection chains. This approach is especially important in the hospital setting where contacts often cannot be avoided and physical distance is usually not possible. Furthermore, health care workers (HCWs) usually have contact with a variety of vulnerable people, making it essential to identify infections among hospital employees as soon as possible to interrupt the rapid spread of SARS-CoV-2 in the facility. Several electronic tools for contact tracing, such as specific software or mobile phone apps, are available for the public health sector. In contrast, contact tracing in hospitals often has to be carried out without helpful electronic tools, and an enormous amount of human resources is typically required. AIM: For rapid contact tracing and effective infection control and management measures for HCWs in hospitals, adapted technical solutions are needed. METHODS: In this study, we report the development of our containment strategy to a web-based contact tracing and rapid point-of-care-testing workflow. RESULTS/CONCLUSION: Our workflow yielded efficient control of the rapidly evolving situation during the SARS-CoV-2 pandemic from May 2020 until January 2021 at a German University Hospital.


Assuntos
Teste de Ácido Nucleico para COVID-19/métodos , COVID-19/transmissão , Redes de Comunicação de Computadores , Busca de Comunicante/métodos , Transmissão de Doença Infecciosa do Paciente para o Profissional , Pandemias , Testes Imediatos , SARS-CoV-2 , COVID-19/epidemiologia , Alemanha/epidemiologia , Hospitais Universitários , Humanos , Controle de Infecções/métodos , Transmissão de Doença Infecciosa do Profissional para o Paciente/prevenção & controle , Aplicativos Móveis , Recursos Humanos em Hospital , Reação em Cadeia da Polimerase em Tempo Real , Estudos Retrospectivos , Estações do Ano , Software , Fluxo de Trabalho
11.
Artigo em Inglês | MEDLINE | ID: mdl-34200231

RESUMO

Standard precautions protect patients and nurses from infection. Nevertheless, compliance with standard precautions is lower among emergency department nurses than other nurses. We examined the individual and organizational factors that influence emergency department nurses' compliance with standard precautions via a cross-sectional study. A self-reported questionnaire survey was administered to 140 nurses working in nine emergency departments in South Korea. It included items regarding ethical awareness and standard precaution self-efficacy at the individual level as well as safety environment, organizational culture for infection control, and degree of compliance with standard precautions at the organizational level. Individual and organizational predictors were identified using a multilevel analysis. The results indicated that 81.1% of nurses' compliance with standard precautions was influenced by individual differences, while only 18.9% was influenced by organizational differences. Individual- and organizational-level predictors explained 46.7% and 55.4% of the variance in emergency department nurses' compliance with standard precautions, respectively. Emergency department nurses' compliance with standard precautions was predicted by ethical awareness and standard precaution self-efficacy at the individual level and by organizational culture for infection control at the organizational level. Our findings provide evidence for the need to improve facilities and human resource management as well as the organizational culture for infection control.


Assuntos
Enfermeiras e Enfermeiros , Recursos Humanos de Enfermagem no Hospital , Estudos Transversais , Serviço Hospitalar de Emergência , Humanos , Controle de Infecções , Análise Multinível , República da Coreia , Inquéritos e Questionários
12.
Isr Med Assoc J ; 23(7): 408-411, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34251121

RESUMO

BACKGROUND: Our hospital used to perform cesarean delivery under general anesthesia rather than neuraxial anesthesia, mostly because of patient refusal of members of the conservative Bedouin society. According to recommendations implemented by the Israeli Obstetric Anesthesia Society, which were implemented due to the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic, we increased the rate of neuraxial anesthesia among deliveries. OBJECTIVES: To compare the rates of neuraxial anesthesia in our cesarean population before and during SARS-CoV-2 pandemic. METHODS: We included consecutive women undergoing an elective cesarean delivery from two time periods: pre-SARS-CoV-2 pandemic (15 February 2019 to 14 April 2019) and during the SARS-CoV-2 pandemic (15 February 2020 to 15 April 2020). We collected demographic data, details about cesarean delivery, and anesthesia complications. RESULTS: We included 413 parturients undergoing consecutive elective cesarean delivery identified during the study periods: 205 before the SARS-CoV-2 pandemic and 208 during SARS-CoV-2 pandemic. We found a statistically significant difference in neuraxial anesthesia rates between the groups: before the pandemic (92/205, 44.8%) and during (165/208, 79.3%; P < 0.0001). CONCLUSIONS: We demonstrated that patient and provider education about neuraxial anesthesia can increase its utilization. The addition of a trained obstetric anesthesiologist to the team may have facilitated this transition.


Assuntos
Anestesia por Condução , Anestesia Geral , Anestesia Obstétrica , Cesárea , Recusa do Paciente ao Tratamento , Adulto , Anestesia por Condução/métodos , Anestesia por Condução/psicologia , Anestesia por Condução/estatística & dados numéricos , Anestesia Geral/métodos , Anestesia Geral/estatística & dados numéricos , Anestesia Obstétrica/métodos , Anestesia Obstétrica/psicologia , Árabes/psicologia , Árabes/estatística & dados numéricos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Cesárea/métodos , Cesárea/estatística & dados numéricos , Salas de Parto/organização & administração , Procedimentos Cirúrgicos Eletivos/métodos , Procedimentos Cirúrgicos Eletivos/estatística & dados numéricos , Feminino , Humanos , Controle de Infecções/métodos , Controle de Infecções/organização & administração , Israel/epidemiologia , Inovação Organizacional , Gravidez , Utilização de Procedimentos e Técnicas/estatística & dados numéricos , Utilização de Procedimentos e Técnicas/tendências , Estudos Retrospectivos , Recusa do Paciente ao Tratamento/etnologia , Recusa do Paciente ao Tratamento/estatística & dados numéricos
14.
Medicine (Baltimore) ; 100(28): e26634, 2021 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-34260556

RESUMO

ABSTRACT: Emergency departments (EDs) are on the frontline of the coronavirus disease (COVID-19) outbreak. To resolve the abrupt overloading of COVID-19-suspected patients in a community, each ED needs to respond in various ways. In our hospital, we increased the isolation beds through temporary remodeling and by performing in-hospital COVID-19 polymerase chain reaction testing rather than outsourcing them. The aim of this study was to verify the effects of our response to the newly developed viral outbreak.The medical records of patients who presented to an ED were analyzed retrospectively. We divided the study period into 3: pre-COVID-19, transition period of response (the period before fully implementing the response measures), and post-response (the period after complete response). We compared the parameters of the National Emergency Department Information System and information about isolation and COVID-19.The number of daily ED patients was 86.8 ±â€Š15.4 in the pre-COVID-19, 36.3 ±â€Š13.6 in the transition period, and 67.2 ±â€Š10.0 in the post-response period (P < .001). The lengths of stay in the ED were significantly higher in transition period than in the other periods [pre-COVID-19 period, 219.0 (121.0-378.0) min; transition period, 301 (150.0-766.5) min; post-response period, 281.0 (114.0-575.0) min; P < .001]. The ratios of use of an isolation room and fever (≥37.5°C) were highest in the post-response period [use of isolation room: pre-COVID-19 period, 0.6 (0.7%); transition period, 1.2 (3.3%); post-response period, 16.1 (24.0%); P < .001; fever: pre-COVID-19 period, 14.8(17.3%); transition period, 6.8 (19.1%); post-response period, 14.5 (21.9%), P < .001].During an outbreak of a novel infectious disease, increasing the number of isolation rooms in the ED and applying a rapid confirmation test would enable the accommodation of more suspected patients, which could help reduce the risk posed to the community and thus prevent strain on the local emergency medical system.


Assuntos
COVID-19 , Surtos de Doenças/estatística & dados numéricos , Serviços Médicos de Emergência/estatística & dados numéricos , Serviço Hospitalar de Emergência/estatística & dados numéricos , Controle de Infecções/estatística & dados numéricos , Adulto , Idoso , Continuidade da Assistência ao Paciente/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Isolamento de Pacientes/estatística & dados numéricos , República da Coreia , Estudos Retrospectivos , SARS-CoV-2
15.
Pan Afr Med J ; 38: 253, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34104301

RESUMO

Introduction: proper tuberculosis (TB) infection control (TBIC) practice of health professionals is one of the effective TB prevention approaches. Despite this reality, the TBIC practice of health care workers was not been well studied. This study assessed the TBIC practice of health professionals and associated factors in Mizan Tepi University Teaching Hospital, southwest Ethiopia. Methods: an institution based quantitative cross-sectional study was conducted from September 1 to 30, 2019, by including all health professionals in the hospital. Participants who answered at least 50% of TBIC practice questions correctly were categorized as having good TBIC practice. Binary logistic regression was used to identify factors associated with the practice of the participants. The odds ratio with a 95% confidence interval and p-value was used to measure the strength of association; the significant association was declared at a p-value less than 0.05. Results: the study found that 64.1% (95% CI: 56.6%, 70.7%) of the participants had good TBIC practice. More than half, 102(51.5 %) of study participants have service years of greater than or equal to five years. Only the service year of health professionals was significantly associated [95%CI (AOR= 2.43; 95%CI: 1.28, 4.6)] with the respondents´ TBIC practice. Conclusion: only less than two-third of health professionals had good TBIC practice which is inadequate. And also experienced staff had significantly better TBIC practice. As a result, health professionals in MTUTH should be supported to practice TBIC as routine activity and opportunities should be made for senior staffs to share their TBIC experiences with others.


Assuntos
Pessoal de Saúde/estatística & dados numéricos , Controle de Infecções/métodos , Tuberculose/prevenção & controle , Adulto , Estudos Transversais , Etiópia , Feminino , Hospitais Universitários , Humanos , Masculino , Inquéritos e Questionários , Fatores de Tempo
16.
Br J Community Nurs ; 26(6): 266-270, 2021 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-34105371

RESUMO

COVID-19 provided significant challenges for community services and care homes. Residential and nursing care patients are considered highly vulnerable to the coronavirus due to their physical needs and environmental factors. Significant concern was raised with personal protective equipment (PPE) availability and appropriate training and support in local care homes. Members of the district nursing team and community services formed a team to deliver face to face training and support to care home workers to improve PPE adherence and reduce risks of transmission. Visits were offered to all 46 care homes in the locality and over 55 visits for teaching were performed in the first month. Challenges were faced with managing and prioritising frontline clinical duties. Feedback was overwhelmingly positive and care staff benefited from face-to-face delivery of education to support best practice.


Assuntos
Pessoal Técnico de Saúde/educação , COVID-19/prevenção & controle , Enfermagem em Saúde Comunitária/educação , Controle de Infecções/métodos , Casas de Saúde , Equipamento de Proteção Individual , Humanos , Equipamento de Proteção Individual/provisão & distribuição , Avaliação de Programas e Projetos de Saúde , SARS-CoV-2 , Reino Unido
17.
Antimicrob Resist Infect Control ; 10(1): 86, 2021 06 03.
Artigo em Inglês | MEDLINE | ID: mdl-34082822

RESUMO

BACKGROUND: Knowledge of infection prevention and control (IPC) procedures among healthcare workers (HCWs) is crucial for effective IPC. Compliance with IPC measures has critical implications for HCWs safety, patient protection and the care environment. AIMS: To discuss the body of available literature regarding HCWs' knowledge of IPC and highlight potential factors that may influence compliance to IPC precautions. DESIGN: A systematic review. A protocol was developed based on the Preferred Reporting Items for Systematic reviews and Meta-Analysis [PRISMA] statement. DATA SOURCES: Electronic databases (PubMed, CINAHL, Embase, Proquest, Wiley online library, Medline, and Nature) were searched from 1 January 2006 to 31 January 2021 in the English language using the following keywords alone or in combination: knowledge, awareness, healthcare workers, infection, compliance, comply, control, prevention, factors. 3417 papers were identified and 30 papers were included in the review. RESULTS: Overall, the level of HCW knowledge of IPC appears to be adequate, good, and/or high concerning standard precautions, hand hygiene, and care pertaining to urinary catheters. Acceptable levels of knowledge were also detected in regards to IPC measures for specific diseases including TB, MRSA, MERS-CoV, COVID-19 and Ebola. However, gaps were identified in several HCWs' knowledge concerning occupational vaccinations, the modes of transmission of infectious diseases, and the risk of infection from needle stick and sharps injuries. Several factors for noncompliance surrounding IPC guidelines are discussed, as are recommendations for improving adherence to those guidelines. CONCLUSION: Embracing a multifaceted approach towards improving IPC-intervention strategies is highly suggested. The goal being to improve compliance among HCWs with IPC measures is necessary.


Assuntos
COVID-19/prevenção & controle , Pessoal de Saúde , Controle de Infecções/métodos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , COVID-19/transmissão , Infecção Hospitalar/prevenção & controle , Bases de Dados Factuais , Fidelidade a Diretrizes , Conhecimentos, Atitudes e Prática em Saúde , Humanos , SARS-CoV-2/isolamento & purificação
18.
Antimicrob Resist Infect Control ; 10(1): 87, 2021 06 04.
Artigo em Inglês | MEDLINE | ID: mdl-34088341

RESUMO

BACKGROUND: During the intensive care units' (ICUs) reorganization that was forced by the COVID-19 emergency, attention to traditional infection control measures may have been reduced. Nevertheless, evidence on the effect of the COVID-19 pandemic on healthcare-associated infections (HAIs) is still limited and mixed. In this study, we estimated the pandemic impact on HAI incidence and investigated the HAI type occurring in COVID-19 patients. METHODS: Patients admitted to the main ICU of the Umberto I teaching hospital of Rome from March 1st and April 4th 2020 were compared with patients hospitalized in 2019. We assessed the association of risk factors and time-to-first event through multivariable Fine and Grey's regression models, that consider the competitive risk of death on the development of HAI (Model 1) or device related-HAI (dr-HAI, Model 2) and provide estimates of the sub-distribution hazard ratio (SHR) and its associated confidence interval (CI). A subgroup analysis was performed on the 2020 cohort. RESULTS: Data from 104 patients were retrieved. Overall, 59 HAIs were recorded, 32 of which occurred in the COVID-19 group. Patients admitted in 2020 were found to be positively associated with both HAI and dr-HAI onset (SHR: 2.66, 95% CI 1.31-5.38, and SHR: 10.0, 95% CI 1.84-54.41, respectively). Despite being not confirmed at the multivariable analysis, a greater proportion of dr-HAIs seemed to occur in COVID-19 patients, especially ventilator-associated pneumonia, and catheter-related urinary tract infections. CONCLUSIONS: We observed an increase in the incidence of patients with HAIs, especially dr-HAIs, mainly sustained by COVID-19 patients. A greater susceptibility of these patients to device-related infections was hypothesized, but further studies are needed.


Assuntos
COVID-19/epidemiologia , Infecção Hospitalar/epidemiologia , Unidades de Terapia Intensiva/estatística & dados numéricos , Idoso , Infecções Relacionadas a Cateter/epidemiologia , Cuidados Críticos , Atenção à Saúde , Feminino , Hospitalização , Hospitais de Ensino , Humanos , Incidência , Controle de Infecções , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Associada à Ventilação Mecânica/epidemiologia , Estudos Retrospectivos , Fatores de Risco , SARS-CoV-2/isolamento & purificação
19.
Plast Reconstr Surg ; 148(1): 168e-169e, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34110314

Assuntos
COVID-19/prevenção & controle , Controle de Infecções/organização & administração , Pandemias/prevenção & controle , Centro Cirúrgico Hospitalar/organização & administração , Cirurgia Plástica/organização & administração , COVID-19/diagnóstico , COVID-19/epidemiologia , COVID-19/transmissão , Teste para COVID-19/normas , Teste para COVID-19/estatística & dados numéricos , Teste para COVID-19/tendências , Egito/epidemiologia , Procedimentos Cirúrgicos Eletivos/normas , Procedimentos Cirúrgicos Eletivos/estatística & dados numéricos , Procedimentos Cirúrgicos Eletivos/tendências , Política de Saúde , Humanos , Controle de Infecções/normas , Controle de Infecções/estatística & dados numéricos , Controle de Infecções/tendências , Procedimentos Cirúrgicos Reconstrutivos/normas , Procedimentos Cirúrgicos Reconstrutivos/estatística & dados numéricos , Procedimentos Cirúrgicos Reconstrutivos/tendências , SARS-CoV-2/isolamento & purificação , Centro Cirúrgico Hospitalar/normas , Centro Cirúrgico Hospitalar/estatística & dados numéricos , Centro Cirúrgico Hospitalar/tendências , Cirurgia Plástica/normas , Cirurgia Plástica/estatística & dados numéricos , Cirurgia Plástica/tendências , Telemedicina/organização & administração , Telemedicina/normas , Telemedicina/estatística & dados numéricos , Centros de Atenção Terciária/organização & administração , Centros de Atenção Terciária/normas , Centros de Atenção Terciária/estatística & dados numéricos , Centros de Atenção Terciária/tendências , Triagem/organização & administração , Triagem/normas , Triagem/estatística & dados numéricos , Triagem/tendências
20.
Medicine (Baltimore) ; 100(25): e26433, 2021 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-34160433

RESUMO

ABSTRACT: The subclinical severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection rate in hospitals during the pandemic remains unclear. To evaluate the effectiveness of our hospital's current nosocomial infection control measures, we conducted a serological survey of anti-SARS-CoV-2 antibodies (immunoglobulin [Ig] G) among the staff of our hospital, which is treating coronavirus disease 2019 (COVID-19) patients.The study design was cross-sectional. We measured anti-SARS-CoV-2 IgG in the participants using a laboratory-based quantitative test (Abbott immunoassay), which has a sensitivity and specificity of 100% and 99.6%, respectively. To investigate the factors associated with seropositivity, we also obtained some information from the participants with an anonymous questionnaire. We invited 1133 staff members in our hospital, and 925 (82%) participated. The mean age of the participants was 40.0 ±â€Š11.8 years, and most were women (80.0%). According to job title, there were 149 medical doctors or dentists (16.0%), 489 nurses (52.9%), 140 medical technologists (14.2%), 49 healthcare providers (5.3%), and 98 administrative staff (10.5%). The overall prevalence of seropositivity for anti-SARS-CoV-2 IgG was 0.43% (4/925), which was similar to the control seroprevalence of 0.54% (16/2970) in the general population in Osaka during the same period according to a government survey conducted with the same assay. Seropositive rates did not significantly differ according to job title, exposure to suspected or confirmed COVID-19 patients, or any other investigated factors.The subclinical SARS-CoV-2 infection rate in our hospital was not higher than that in the general population under our nosocomial infection control measures.


Assuntos
Anticorpos Antivirais/sangue , Infecções Assintomáticas/epidemiologia , COVID-19/epidemiologia , Pessoal de Saúde/estatística & dados numéricos , Estudos Soroepidemiológicos , Adulto , COVID-19/sangue , COVID-19/imunologia , COVID-19/transmissão , Estudos Transversais , Feminino , Hospitais Urbanos/organização & administração , Hospitais Urbanos/normas , Hospitais Urbanos/estatística & dados numéricos , Humanos , Imunoglobulina G/sangue , Controle de Infecções/organização & administração , Controle de Infecções/normas , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Transmissão de Doença Infecciosa do Paciente para o Profissional/estatística & dados numéricos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Pandemias/estatística & dados numéricos , Prevalência , Fatores de Risco , SARS-CoV-2/imunologia , Inquéritos e Questionários/estatística & dados numéricos
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