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1.
Rev Esp Salud Publica ; 952021 Jun 07.
Artigo em Espanhol | MEDLINE | ID: mdl-34092784

RESUMO

OBJECTIVE: Hospital emergency services have specific care characteristics that make them more vulnerable to the risk of legal claims. The fact of suffering a legal claim for professional practice is a very traumatic event. The objective of this study was to find out the opinion of the professionals of the hospital emergency services in Spain on the importance of practices associated with defensive medicine. METHODS: Survey of 1,449 professionals from public and private hospital emergency services throughout the national territory was made, in the period between March 13th and April 3rd, 2017. A univariate analysis was performed to identify variables in relation to the practice of defensive medicine, and the determination of the groups of greater association (chi2 test) to evaluate these variables. RESULTS: 96.1% expressed the need to strengthen their medical-legal training. 91.3% of the cases felt more legal pressure and 88.7% declared that they act conditioned by the threat of judicial claim. Regarding patient treatments, 89.8% stated that they perform diagnostic tests that may not be necessary and 63% of professionals stated that they extend the stay of patients in the emergency department. As for the healthcare organization, 88% declared that they do not feel protected by the structure and 79.1% do not felt support from the center's management. CONCLUSIONS: Practices associated with defensive medicine are frequent in our country, with a high proportion of criminal proceedings, and the two main causes are dispensable diagnostic tests and unnecessary prolongation of length of stay.


Assuntos
Atitude do Pessoal de Saúde , Medicina Defensiva/organização & administração , Serviço Hospitalar de Emergência/organização & administração , Recursos Humanos em Hospital/psicologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recursos Humanos em Hospital/estatística & dados numéricos , Espanha , Inquéritos e Questionários
2.
Br J Nurs ; 30(11): 634-642, 2021 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-34109816

RESUMO

BACKGROUND: Although the mental health burden in healthcare workers caused by COVID-19 has gained increasing attention both within the profession and through public opinion, there has been a lack of data describing their experience; specifically, the mental wellbeing of healthcare workers in the intensive care unit (ICU), including those redeployed. AIMS: The authors aimed to compare the mental health status of ICU healthcare workers (physicians, nurses and allied health professionals) affected by various factors during the COVID-19 pandemic; and highlight to policymakers areas of staff vulnerabilities in order to improve wellbeing strategies within healthcare systems. METHODS: An online survey using three validated scales was conducted in France, the UK, Italy, Mainland China, Taiwan, Egypt and Belgium. FINDINGS: The proportion of respondents who screened positive on the three scales across the countries was 16-49% for depression, 60-86% for insomnia and 17-35% for post-traumatic stress disorder. The authors also identified an increase in the scores with longer time spent in personal protective equipment, female gender, advancing age and redeployed status. CONCLUSION: The high prevalence of mental disorders among ICU staff during the COVID-19 crisis should inform local and national wellbeing policies.


Assuntos
COVID-19 , Saúde Global , Unidades de Terapia Intensiva , Transtornos Mentais , Recursos Humanos em Hospital , COVID-19/epidemiologia , COVID-19/terapia , Feminino , Saúde Global/estatística & dados numéricos , Inquéritos Epidemiológicos , Humanos , Transtornos Mentais/epidemiologia , Recursos Humanos em Hospital/psicologia , Recursos Humanos em Hospital/estatística & dados numéricos
3.
J Patient Saf ; 17(4): 323-330, 2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-33994534

RESUMO

BACKGROUND: Although recommendations to prevent COVID-19 healthcare-associated infections (HAIs) have been proposed, data on their effectivity are currently limited. OBJECTIVE: The aim was to evaluate the effectivity of a program of control and prevention of COVID-19 in an academic general hospital in Spain. METHODS: We captured the number of COVID-19 cases and the type of contact that occurred in hospitalized patients and healthcare personnel (HCP). To evaluate the impact of the continuous use of a surgical mask among HCP, the number of patients with COVID-19 HAIs and accumulated incidence of HCP with COVID-19 was compared between the preintervention and intervention periods. RESULTS: Two hundred fifty-two patients with COVID-19 have been admitted to the hospital. Seven of them had an HAI origin (6 in the preintervention period and 1 in the intervention period). One hundred forty-two HCP were infected with SARS-CoV-2. Of them, 22 (15.5%) were attributed to healthcare (2 in the emergency department and none in the critical care departments), and 120 (84.5%) were attributed to social relations in the workplace or during their non-work-related personal interactions. The accumulated incidence during the preintervention period was 22.3 for every 1000 HCP and 8.2 for every 1000 HCP during the intervention period. The relative risk was 0.37 (95% confidence interval, 0.25 to 0.55) and the attributable risk was -0.014 (95% confidence interval, -0.020 to -0.009). CONCLUSIONS: A program of control and prevention of HAIs complemented with the recommendation for the continuous use of a surgical mask in the workplace and social environments of HCP effectively decreased the risk of COVID-19 HAIs in admitted patients and HCP.


Assuntos
Centros Médicos Acadêmicos , Infecção Hospitalar/prevenção & controle , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Adulto , /transmissão , Infecção Hospitalar/epidemiologia , Feminino , Humanos , Incidência , Transmissão de Doença Infecciosa do Paciente para o Profissional/estatística & dados numéricos , Masculino , Máscaras/estatística & dados numéricos , Pessoa de Meia-Idade , Recursos Humanos em Hospital/estatística & dados numéricos , Avaliação de Programas e Projetos de Saúde , Medição de Risco/estatística & dados numéricos , Espanha/epidemiologia
4.
Artigo em Inglês | MEDLINE | ID: mdl-34000153

RESUMO

OBJECTIVE: To investigate the prevalence of depression, anxiety, and insomnia among hospital staff working in a tertiary care private hospital in India during the early period of the coronavirus disease 2019 (COVID-19) pandemic. METHODS: This cross-sectional study was conducted May 5-25, 2020, among 347 hospital staff (nursing and other hospital staff, with the exception of doctors). Depression, anxiety, and insomnia were measured using the 9-item Patient Health Questionnaire, the 7-item Generalized Anxiety Disorder Scale, and the Insomnia Severity Index, respectively. RESULTS: Of respondents, 16.4% reported clinically significant depression, 13.8% reported clinically significant anxiety, and 13.3% reported insomnia. Among the nursing staff, 20.9% reported clinically significant depression, 15.9% reported clinically significant anxiety, and 17.0% reported insomnia. There was significantly higher depression (P = .000), anxiety (P = .002), and insomnia (P = .007) among nursing staff compared with other hospital staff in 2-tailed t tests. There was a significantly higher prevalence of insomnia among females (χ2 = 5.85, df = 2, P = .05). CONCLUSIONS: Study results show that more than 1 in 10 hospital staff suffer from mental health conditions, even during the beginning of the pandemic, and there is a need for active psychiatric support for the hospital staff during this pandemic. Depression, anxiety, and insomnia are significantly higher among nurses compared to other hospital staff. The results of this research suggest that comprehensive support measures should be implemented to protect and maintain mental health of hospital staff, especially nurses, while fighting the COVID-19 pandemic.


Assuntos
Transtornos de Ansiedade/epidemiologia , Transtorno Depressivo/epidemiologia , Hospitais Privados/estatística & dados numéricos , Recursos Humanos em Hospital/psicologia , Recursos Humanos em Hospital/estatística & dados numéricos , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Centros de Atenção Terciária/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Recursos Humanos de Enfermagem no Hospital/psicologia , Recursos Humanos de Enfermagem no Hospital/estatística & dados numéricos
5.
Psychoneuroendocrinology ; 128: 105213, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33845387

RESUMO

In the critical context of COVID-19 pandemic, healthcare workers are on the front line, participating directly in the care, diagnosis, and treatment of patients with COVID-19. This exposes them to a higher risk of developing chronic stress, psychological distress, and any other mental health symptoms. OBJECTIVE: to evaluate stress and burnout in a health workers population and, in addition, to measure hair cortisol concentration as a current biomarker of stress. MATERIALS AND METHODS: 234 health workers from Hospital de Clínicas "José de San Martín", Buenos Aires University, were included in this study. In this population hair samples were obtained from the posterior vertex as close to the scalp as possible and the individuals completed the following surveys: perceived stress, social support, burnout scale, life event scale, and sociodemographic data. Hair cortisol was measured by an automated chemiluminescent method. The studied population was divided into three groups considering those individuals below the healthy reference sample range (< 40 pg/mg hair), within the healthy reference range (40-128 pg/mg hair) and above the reference range (> 128 pg/mg hair). This study used a transversal and observational design. RESULTS: Our results show that 40% of the studied population presented hair cortisol values outside of the healthy reference range. In the whole studied population, a direct correlation was found between hair cortisol concentration and perceived stress as well as between hair cortisol concentration and the emotional exhaustion component of burnout (r = 0.142, p = 0.030; r = 0.143, p = 0.029, respectively). 12% of the studied population showed Burnout (52% doctors and residents, 19% nurses, 19% administrative personnel). Higher values in hair cortisol levels were found in the group with burnout versus individuals without burnout (p = 0.034). Finally, a mediation analysis was performed, finding that depersonalization is a mediating variable in the relationship between self-perceived stress and hair cortisol level (F = 4.86, p = 0.0086; indirect effect IC: 0.0987-1.8840). CONCLUSION: This is the first study in which a stress biomarker such as hair cortisol is evaluated in this population and in this context. Healthcare workers are subjected to increased levels of stress and burnout. High depersonalization, emotional exhaustion, and decreased personal sense of accomplishment characterize this population. It is the responsibility of the health authorities to implement strategies to manage this psychological emergency.


Assuntos
Hidrocortisona/metabolismo , Estresse Ocupacional/diagnóstico , Estresse Ocupacional/metabolismo , Recursos Humanos em Hospital/psicologia , Adulto , Argentina/epidemiologia , Esgotamento Profissional/diagnóstico , Esgotamento Profissional/epidemiologia , Esgotamento Profissional/metabolismo , Esgotamento Profissional/fisiopatologia , Feminino , Cabelo/química , Pesquisas sobre Serviços de Saúde , Hospitais Universitários/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Estresse Ocupacional/epidemiologia , Estresse Ocupacional/fisiopatologia , Recursos Humanos em Hospital/estatística & dados numéricos
6.
PLoS One ; 16(4): e0238088, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33793556

RESUMO

BACKGROUND: COVID-19 seroprevalence data, particularly in less developed countries with a relatively low incidence, has been scant. We aimed to explore the seroprevalence of hospital staff in the area with zero confirmed COVID-19 case to shed light on the situation of COVID-19 infection in zero or low infection rate countries where mass screening was not readily available. METHODS: A locally developed rapid immunoglobulin M (IgM)/immunoglobulin G (IgG) test kit was used for hospital staff screening of Ranong hospital which is located in a province with zero COVID-19 prevalence in Thailand from 17th April to 17th May 2020. All staff was tested, 100 of which were randomly invited to have a repeating antibody test in one month. (Thai Clinical Trials Registry: TCTR20200426002). RESULTS: Of 844 hospital staff, 82 were tested twice one month apart (response rate for repeating antibody test 82%). Overall, 0.8% of the participants (7 of 844) had positive IgM, none had positive IgG. Female staff had 1.0% positive IgM (95% CI: 0.5-2.1%) while male had 0.5% positive IgM (95% CI: 0.1-2.6%). No participants with a history of travel to the high-risk area or close contact with PCR-confirmed COVID-19 case developed SARS-CoV-2 antibodies. Among 844 staff, 811 had no symptoms and six of them developed IgM seropositive (0.7%) while 33 had minor symptoms and only one of them developed IgM seropositive (3.0%). No association between SARS-CoV-2 IgM status and gender, history of travel to a high-risk area, close contact with PCR-confirmed or suspected COVID-19 case, presence of symptoms within 14 days, or previous PCR status was found. None of the hospital staff developed SARS-CoV-2 IgG. CONCLUSIONS: COVID-19 antibody test could detect a considerable number of hospital staff who could be potential silent spreaders in a province with zero COVID-19 cases. Accurate antibody testing is a valuable screening tool, particularly in asymptomatic healthcare workers. Trial registration: This study was approved by the Institutional Review Board of Chulalongkorn University (IRB No.236/63) and the Institutional Review Board of Ranong Hospital. (Thai Clinical Trials Registry: TCTR20200426002).


Assuntos
Anticorpos Antivirais/sangue , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Recursos Humanos em Hospital/estatística & dados numéricos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Soroepidemiológicos , Tailândia/epidemiologia
7.
Healthc Q ; 24(1): 44-49, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33864440

RESUMO

Pandemics are associated with heightened distress among healthcare workers (HCWs). We report qualitative findings from a two-stage survey administered to HCWs at a large acute care hospital in Ontario during the COVID-19 pandemic to identify their concerns and wellness needs. Responses reflected HCWs' desires to be heard, protected, prepared, supported and cared for by the organization. HCWs' concerns were diverse and dynamic, reflecting the specific circumstances of their work and personal lives as well as the shifting landscape of the pandemic. We discuss implications for organizations seeking to promote and protect HCWs' psychological well-being and resilience during pandemics.


Assuntos
/epidemiologia , Pessoal de Saúde/psicologia , /prevenção & controle , Pessoal de Saúde/normas , Pessoal de Saúde/estatística & dados numéricos , Humanos , Doenças Profissionais/prevenção & controle , Doenças Profissionais/psicologia , Recursos Humanos em Hospital/psicologia , Recursos Humanos em Hospital/normas , Recursos Humanos em Hospital/estatística & dados numéricos , Inquéritos e Questionários
8.
J Prim Care Community Health ; 12: 21501327211002099, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33719717

RESUMO

INTRODUCTION: Health care workers (HCWs) are at the forefront to fight against COVID-19 pandemic. They are at more risk of contracting the infection. This study was planned to assess potential risk factors of 2019-novel coronavirus infection among HCWs working in a health facility and to evaluate the effectiveness of infection prevention and control measures among them. METHODS: A study was conducted in a tertiary care hospital among HCWs who were directly or indirectly involved in the management of a confirmed or suspected case of COVID-19. The socio-demographic characteristics, history of exposure, IPC measures followed and clinical symptoms were compared between health care workers in COVID and non-COVID areas. RESULTS: Majority (45%) of HCWs were nurses, followed by hospital/sanitary/technical attendants (30%) and doctors (24%). Out of a total of 256 HCWs, 2% tested positive. Around 80% of HCWs had ever attended any IPC training. A statistically significant association was found between posting area of HCWs and their exposure to COVID patients (duration of exposure, PPE has worn by HCWs, direct contact of HCWs with the patient's material) and COVID positivity (P value <.001). CONCLUSION: If health care workers were trained and take adequate precautions then the risk of getting an infection is minimized.


Assuntos
/prevenção & controle , Controle de Infecções/organização & administração , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Recursos Humanos em Hospital , Adulto , Feminino , Humanos , Índia/epidemiologia , Masculino , Equipamento de Proteção Individual , Recursos Humanos em Hospital/estatística & dados numéricos , Medição de Risco , Fatores de Risco , Centros de Atenção Terciária , Adulto Jovem
9.
Eur J Cancer ; 148: 359-370, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33780664

RESUMO

BACKGROUND: In view of the potential gravity of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection for patients with cancer, epidemiological data are vital to assess virus circulation among patients and staff of cancer centres. We performed a prospective study to investigate seroprevalence of SARS-CoV-2 antibodies among staff and patients with cancer at a large cancer centre, at the end of the period of first national lockdown in France and to determine factors associated with the risk of SARS-CoV-2 infection. METHODS: After the first lockdown, all medical and non-medical staff, as well as all patients attending the medical oncology department were invited to undergo serological testing for SARS-CoV-2 between 11 May and 30 June 2020. All participants were also invited to complete a questionnaire collecting data about their living and working conditions, and for patients, medical management during lockdown. FINDINGS: A total of 1,674 subjects (663 staff members, 1011 patients) were included. Seroprevalence was low in both staff (1.8%) and patients (1.7%), despite more features of high risk for severe forms among patients. None of the risk factors tested in our analysis (working or living conditions, comorbidities, management characteristics during lockdown) was found to be statistically associated with seroprevalence in either staff or patients. There was no significant difference in the proportion of symptomatic and asymptomatic subjects between staff and patients. Only fever, loss of smell, and loss of taste were significantly more frequent among seropositive patients, in both staff and patients. INTERPRETATION: We report very low seroprevalence of antibodies against SARS-CoV-2 in the staff (caregiving and non-caregiving) and patients of a large cancer care centre in which strict hygiene, personal protection, and social distancing measures were implemented.


Assuntos
/epidemiologia , Institutos de Câncer , Pessoal de Saúde/estatística & dados numéricos , Recursos Humanos em Hospital/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Portador Sadio/epidemiologia , Portador Sadio/imunologia , Criança , Pré-Escolar , Feminino , França/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Soroepidemiológicos , Adulto Jovem
10.
J Psychiatr Res ; 137: 298-302, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33735720

RESUMO

BACKGROUND: The coronavirus disease 2019 (COVID-19) has affected all countries in the world. Hospital workers are at high risk of mental illness, such as anxiety and depression. Furthermore, they also face many social stresses, such as deterioration of human relations and income reduction. Apart from mental illness, these social stresses can reduce motivation and lead to voluntary absenteeism, which contribute to a collapse of medical systems. Thus, for maintaining medical systems, it is crucial to clarify risk factors for both mental illness and increased social stress among hospital workers. However, little attention has been paid to factors affecting social stress, and thus, we aimed to address this gap. METHODS: In this cross-sectional survey of 588 hospital workers, the levels of anxiety, depression, and social stress were assessed using the 7-item Generalized Anxiety Disorder scale (GAD-7), 9-item Patient Health Questionnaire (PHQ-9), and Tokyo Metropolitan Distress Scale for Pandemic (TMDP). Multiple regression analyses were conducted to identify the demographic variables affecting these problems. RESULTS: Older age and female sex were common risk factors for anxiety, depression, and social stress. Moreover, occupational exposure to COVID-19 and hospital staff other than doctors/fewer non-work days were risk factors for increased anxiety and depression, respectively. Furthermore, living with families/others was a risk factor for increased social stress during this pandemic. CONCLUSION: Our findings could be useful for developing policies and practices to minimize the risk of mental illness and increased social stress among hospital workers, highlighting that attention should be paid to social factors, such as an individual's household situation.


Assuntos
/epidemiologia , Saúde Mental/estatística & dados numéricos , Pandemias , Recursos Humanos em Hospital/psicologia , Recursos Humanos em Hospital/estatística & dados numéricos , Adulto , Ansiedade/epidemiologia , Transtornos de Ansiedade/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Feminino , Humanos , Japão/epidemiologia , Masculino , Estresse Psicológico/epidemiologia
12.
Rev. Asoc. Esp. Espec. Med. Trab ; 30(1): 73-80, mar. 2021. tab
Artigo em Espanhol | IBECS | ID: ibc-ET6-2177

RESUMO

OBJETIVO: Describir la percepción de la violencia laboral externa del personal del Instituto Nacional de Salud del Niño durante el 2019. Material y MÉTODOS: Estudio Observacional, analítico, transversal en el cual participaron trabajadores de salud del INSN que tenían contacto directo con los pacientes y/ o sus familiares durante el año 2019. Se realizó un muestreo estratificado, incluyendo a los grupos ocupacionales: personal administrativo, de servicio, profesional y técnico. Se aplicó la encuesta "Workplace Violence In The Health Sector Country Case Studies Research Instruments Survey Questionnaire 2003", la cual fue traducida y adaptada al español en estudios previos. Previo control de calidad, se realizó un análisis estadístico descriptivo de los datos, y empleando el software STATA V.11 se realizó un análisis bivariado para encontrar los factores asociados a dicha percepción. RESULTADOS: El 82,1% del personal entrevistado fueron mujeres, 36,7% tiene más de 50 años, alrededor del 80% son médicos, enfermeras y técnicas de enfermería. En el INSN el 91,9% de los evaluados perciben violencia generada por el usuario hacia el personal que labora en la institución; asimismo el 75,3% de los que perciben violencia fueron mujeres. Se encontraron diferencias significativas (p < 0,001) en la percepción de la violencia según grupo ocupacional. CONCLUSIONES: Existe asociación entre el tipo de ocupación y la percepción de la violencia laboral externa en el personal del Instituto Nacional de Salud del Niño-Perú


OBJECTIVE: Describe the perception of external workplace violence of the staff of the National Institute of Child Health during 2019. MATERIAL AND METHODS: Observational, analytical, cross-sectional study in which health workers from the INSN who had direct contact with the patients and / or their families during 2019. A stratified sampling was carried out, including occupational groups: administrative, service, professional and technical personnel. The survey "Workplace Violence In The Health Sector Country Case Studies Research Instruments Survey Questionnaire 2003" was applied, which was translated and adapted into Spanish in previous studies. Prior to quality control, a descriptive statistical analysis of the data was performed, and using the STATA V.11 software, a bivariate analysis was performed to find the factors associated with such perception. RESULTS: 82.1% of the personnel interviewed were women, 36.7% are over 50 years old, around 80% are doctors, nurses and nursing technicians. In the INSN, 91.9% of those evaluated perceive violence generated by the user towards the personnel working in the institution; likewise, 75.3% of those who perceived violence were women. Significant differences (p < 0.001) were found in the perception of violence according to occupational group. CONCLUSIONS: There is an association between the type of occupation and the perception of external work violence in the personnel of the National Institute of Child Health-Peru


Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Violência no Trabalho/estatística & dados numéricos , Hospitais Pediátricos/estatística & dados numéricos , Recursos Humanos em Hospital/estatística & dados numéricos , Estudos Transversais , Percepção , Fatores Socioeconômicos , Inquéritos e Questionários , Peru
13.
BMJ Open ; 11(2): e047216, 2021 02 22.
Artigo em Inglês | MEDLINE | ID: mdl-33619203

RESUMO

OBJECTIVES: To assess the seroprevalence of anti-SARS-CoV-2 IgG among health careworkers (HCWs) in our university hospital and verify the risk of acquiring the infection according to work area. DESIGN: Cross-sectional study. SETTING: Monocentric, Italian, third-level university hospital. PARTICIPANTS: All the employees of the hospital on a voluntary base, for a total of 4055 participants among 4572 HCWs (88.7%). PRIMARY AND SECONDARY OUTCOME MEASURES: Number of anti-SARS-CoV-2 positive serology according to working area. Association of anti-SARS-CoV-2 positive serology to selected variables (age, gender, country of origin, body mass index, smoking, symptoms and contact with confirmed cases). RESULTS: From 27 April 2020 to 12 June 2020, 4055 HCWs were tested and 309 (7.6%) had a serological positive test. No relevant difference was found between men and women (8.3% vs 7.3%, p=0.3), whereas a higher prevalence was observed among foreign-born workers (27/186, 14.5%, p<0.001), employees younger than 30 (64/668, 9.6%, p=0.02) or older than 60 years (38/383, 9.9%, p=0.02) and among healthcare assistants (40/320, 12.5%, p=0.06). Working as frontline HCWs was not associated with an increased frequency of positive serology (p=0.42). A positive association was found with presence and number of symptoms (p<0.001). The symptoms most frequently associated with a positive serology were taste and smell alterations (OR 4.62, 95% CI: 2.99 to 7.15) and fever (OR 4.37, 95% CI: 3.11 to 6.13). No symptoms were reported in 84/309 (27.2%) HCWs with positive IgG levels. Declared exposure to a suspected/confirmed case was more frequently associated (p<0.001) with positive serology when the contact was a family member (19/94, 20.2%) than a patient or colleague (78/888, 8.8%). CONCLUSIONS: SARS-CoV-2 infection occurred undetected in a large fraction of HCWs and it was not associated with working in COVID-19 frontline areas. Beyond the hospital setting, exposure within the community represents an additional source of infection for HCWs.


Assuntos
Anticorpos Antivirais , Imunoglobulina G , Recursos Humanos em Hospital , Adulto , Anticorpos Antivirais/sangue , /epidemiologia , Estudos Transversais , Feminino , Hospitais Universitários , Humanos , Imunoglobulina G/sangue , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Recursos Humanos em Hospital/estatística & dados numéricos , Estudos Soroepidemiológicos
14.
BMC Infect Dis ; 21(1): 233, 2021 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-33639871

RESUMO

BACKGROUND: The risk of hepatitis B virus infection among medical waste handlers who undergo collection, transportation, and disposal of medical wastes in the health institutions is higher due to frequent exposure to contaminated blood and other body fluids. There is limited evidence on the seroprevalence of hepatitis B among medical waste handlers in eastern Ethiopia. The study was aimed at studying the seroprevalence of Hepatitis B Virus and associated risk factors among medical waste collectors at health facilities of eastern Ethiopia. METHODS: A facility-based cross-sectional study was conducted among randomly selected medical waste collectors from public health facilities in eastern Ethiopia from March to June 2018. A pre-tested and well-structured questionnaire was used to collect data on socio-demographic characteristics and hepatitis B infection risk factors. A2.5ml venous blood was also collected, centrifuged and the serum was analyzed for hepatitis B surface antigen using the instant hepatitis B surface antigen kit. Descriptive summary measures were done. Chi-square and Fisher exact tests were used to assess the risk of association. Multivariate logistic regression was conducted with 95% CI and all value at P-value < 0.05 was declared statistically significant. RESULTS: From a total of 260 (97.38%) medical waste collectors participated, HBV was detected in 53 (20.4%) of the participants [95%CI; 15.8, 25.6]. No significant differences were observed in the detection rates of HBV with respect to socio-demographic characteristics. In both bivariate and multivariable logistic regression analysis, being unvaccinated (AOR = 6.35; 95%CI = [2.53-15.96], P = 0.001), history of blood transfusion (receiving) (AOR; 3.54; 95%CI; [1.02-12.24], P = 0.046), history of tattooing (AOR = 2.86; 95%CI = [1.12-7.27], p = 0.03), and history of multiple sexual partner (AOR = 10.28; 95%CI = [4.16-25.38], P = 0.001) remained statistically significantly associated with HBsAg positivity. CONCLUSION: This cross-sectional study identified that HBV infection is high among medical waste collectors in eastern Ethiopia. Immunization and on job health promotion and disease prevention measures should be considered in order to control the risk of HBV infection among medical waste collectors in eastern Ethiopia.


Assuntos
Hepatite B/epidemiologia , Serviço Hospitalar de Limpeza/estatística & dados numéricos , Eliminação de Resíduos de Serviços de Saúde/estatística & dados numéricos , Exposição Ocupacional/estatística & dados numéricos , Recursos Humanos em Hospital/estatística & dados numéricos , Adulto , Centros Comunitários de Saúde/estatística & dados numéricos , Infecção Hospitalar/sangue , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/etiologia , Estudos Transversais , Escolaridade , Etiópia/epidemiologia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Hepatite B/sangue , Hepatite B/etiologia , Antígenos de Superfície da Hepatite B/sangue , Vírus da Hepatite B/isolamento & purificação , Vírus da Hepatite B/fisiologia , Hospitais Públicos/estatística & dados numéricos , Humanos , Masculino , Resíduos de Serviços de Saúde/efeitos adversos , Resíduos de Serviços de Saúde/estatística & dados numéricos , Pessoa de Meia-Idade , Exposição Ocupacional/análise , Logradouros Públicos/estatística & dados numéricos , Fatores de Risco , Estudos Soroepidemiológicos , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
15.
BMC Infect Dis ; 21(1): 234, 2021 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-33639873

RESUMO

BACKGROUND: The goals of the National Action Plan on Antimicrobial Resistance (AMR) of Japan include "implementing appropriate infection prevention and control" and "appropriate use of antimicrobials," which are relevant to healthcare facilities. Specifically, linking efforts between existing infection control teams and antimicrobial stewardship programs was suggested to be important. Previous studies reported that human resources, such as full-time equivalents of infection control practitioners, were related to improvements in antimicrobial stewardship. METHODS: We posted questionnaires to all teaching hospitals (n = 1017) regarding hospital countermeasures against AMR and infections. To evaluate changes over time, surveys were conducted twice (1st survey: Nov 2016, 2nd survey: Feb 2018). A latent transition analysis (LTA) was performed to identify latent statuses, which refer to underlying subgroups of hospitals, and effects of the number of members in infection control teams per bed on being in the better statuses. RESULTS: The number of valid responses was 678 (response rate, 66.7%) for the 1st survey and 559 (55.0%) for the 2nd survey. More than 99% of participating hospitals had infection control teams, with differences in activity among hospitals. Roughly 70% had their own intervention criteria for antibiotics therapies, whereas only about 60 and 50% had criteria established for the use of anti-methicillin-resistant Staphylococcus aureus antibiotics and broad-spectrum antibiotics, respectively. Only 50 and 40% of hospitals conducted surveillance of catheter-associated urinary tract infections and ventilator-associated pneumonia, respectively. Less than 50% of hospitals used maximal barrier precautions for central line catheter insertion. The LTA identified five latent statuses. The membership probability of the most favorable status in the 2nd study period was slightly increased from the 1st study period (23.6 to 25.3%). However, the increase in the least favorable status was higher (26.3 to 31.8%). Results of the LTA did not support a relationship between increasing the number of infection control practitioners per bed, which is reportedly related to improvements in antimicrobial stewardship, and being in more favorable latent statuses. CONCLUSIONS: Our results suggest the need for more comprehensive antimicrobial stewardship programs and increased surveillance activities for healthcare-associated infections to improve antimicrobial stewardship and infection control in hospitals.


Assuntos
Anti-Infecciosos/uso terapêutico , Gestão de Antimicrobianos/métodos , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/prevenção & controle , Farmacorresistência Bacteriana , Hospitais de Ensino , Antibacterianos/uso terapêutico , Gestão de Antimicrobianos/normas , Infecções Relacionadas a Cateter/tratamento farmacológico , Infecções Relacionadas a Cateter/epidemiologia , Infecções Relacionadas a Cateter/prevenção & controle , Infecção Hospitalar/epidemiologia , Higiene das Mãos/normas , Higiene das Mãos/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Hospitais de Ensino/normas , Hospitais de Ensino/estatística & dados numéricos , Humanos , Controle de Infecções/métodos , Controle de Infecções/normas , Japão/epidemiologia , Recursos Humanos em Hospital/estatística & dados numéricos , Pneumonia Associada à Ventilação Mecânica/tratamento farmacológico , Pneumonia Associada à Ventilação Mecânica/epidemiologia , Pneumonia Associada à Ventilação Mecânica/prevenção & controle , Padrões de Prática Médica/normas , Inquéritos e Questionários
16.
Diagn Microbiol Infect Dis ; 100(1): 115330, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33571860

RESUMO

SARS-CoV-2 pandemic shows the importance of having efficient virus diagnosis, especially in groups of particular relevance such as health care professionals, without involving a large economic expense. This is a prevalence study carried out in 7400 health care professionals in a 1350-bed hospital in Madrid, Spain. Pools of 10 samples were performed, using the Xpert® Xpress SARS-CoV-2 test for the diagnosis from clinical samples of nasopharyngeal exudate. A previous study was performed to evaluate the effect of the dilution in terms of sensitivity. The estimated sensitivity was over 95%. A total of 740 pools were performed, with a final result of 218 health care professionals being positive. Using the pooling system, the reagent cost reduction to the institution was 75.3%. It can be concluded that the described sample pooling system is a useful and efficient tool in the diagnosis of SARS-CoV-2 in certain groups, assuming a cost reduction without reducing the sensitivity.


Assuntos
/métodos , Recursos Humanos em Hospital/estatística & dados numéricos , Reação em Cadeia da Polimerase/métodos , /epidemiologia , Reações Falso-Positivas , Humanos , Nasofaringe/virologia , Prevalência , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Espanha/epidemiologia , Manejo de Espécimes/métodos
17.
J. healthc. qual. res ; 36(1): 3-11, ene.-feb. 2021. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-196570

RESUMO

OBJETIVO: Describir el proceso de planificación y ejecución de un estudio masivo de seroprevalencia para SARS-CoV-2 en los profesionales del Hospital Universitario Fundación Alcorcón (HUFA) (España). MÉTODO: Se efectúa una descripción del plan diseñado y desarrollado en el HUFA para la realización de las extracciones de las muestras para serología en el total de los profesionales que prestan servicio en el hospital, entre el 14 y el 29 de abril del 2020. Se lleva a cabo un análisis descriptivo de la participación de los profesionales en el estudio. De igual manera, se planificaron zonas de extracción, personal sanitario y tiempos de ejecución. Se asignaron 2.326 extracciones a personal sanitario, el resto fueron a trabajadores de las empresas externas. RESULTADOS: Participaron en el estudio 2.641 trabajadores (90,5%) de 2.918 candidatos. La categoría profesional que más se analizó globalmente fue la de enfermería con un 28,3% (n = 590). El porcentaje de cumplimiento de la organización de los horarios fue del 28,6%. Se planificó hasta un máximo de 298 extracciones diarias. El día con más afluencia fue el cuarto con 399 extracciones. CONCLUSIONES: El hecho de organizar un dispositivo tan grande con un alcance al 100% de los trabajadores que prestan servicio en el hospital, y con una respuesta tan mayoritaria por parte de ellos, ha permitido que el estudio de seroprevalencia realizado obtenga unos resultados con alta fiabilidad. Aunque el porcentaje de participación fue muy alto, el grado de cumplimiento de la planificación fue reducido


OBJECTIVE: To describe the planning and execution process of a massive seroprevalence study for SARS-CoV-2 in professionals of the Hospital Universitario Fundación Alcorcón (HUFA) (Spain). METHODS: A description is presented of the plan designed and developed at the HUFA for the execution of the extraction of the samples for serology from all the professionals who worked in the hospital between 14 and 29 April 2020. A descriptive analysis of the participation of the professionals in the study is carried out. Extraction areas, health personnel, and execution times were planned. A total of 2326 extractions were assigned to health personnel, the remaining extractions were assigned to workers from external companies. RESULTS: A total of 2641 workers (90.5%) out of 2918 candidates participated in the study. The professional category most analysed was nursing with 28.3% (n = 590). The percentage of compliance with schedule planning was 28.6%. Up to a maximum of 298 daily extractions were planned. The busiest day was the 4th day of the study with 399 extractions. CONCLUSIONS: The organising of such a large study, with a 100% coverage of those who worked in the hospital, and with such a great response from the workers involved, has led to obtaining results of high reliability in the seroprevalence study carried out. Although the percentage of participation was very high, the level of compliance with the planning was low


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Pandemias , Recursos Humanos em Hospital/estatística & dados numéricos , Hospitais Públicos/estatística & dados numéricos , Estudos Soroepidemiológicos , Espanha/epidemiologia
18.
Med J Malaysia ; 76(1): 24-28, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33510104

RESUMO

INTRODUCTION: COVID-19 is a highly transmissible respiratory virus that has affected millions of people worldwide in the span of months. The burden of disease among healthcare workers (HCW) has not been well studied despite reports of infectivity and transmission around the world. Two HCW in Hospital Teluk Intan (HTI) contracted COVID-19 while attending a social event. They were in close proximity with colleagues upon returning to work, resulting in the spread of infection among other HCW in HTI. OBJECTIVE: The objectives of this paper are to gain a better understanding of the key presenting symptoms of COVID-19 in HCWs in a district specialist hospital, to establish the proportion of symptomatic COVID-19 cases among HCWs and its severity and to determine the time taken from onset of symptoms or perceived exposure to diagnostic testing. METHODOLOGY: This is a retrospective descriptive analysis of clinical characteristics of subjects infected with COVID-19 among HCW in HTI. Their demography and clinical characteristics were recorded. RESULTS: There were 47 HCW in HTI who tested positive for COVID-19. The mean age of the patients was 37.5 years old. 7 patients (15.2%) had at least more than one comorbidity. Average duration of time from perceived close contact to onset of symptom was 4.5 days, while the mean duration of time from symptoms to first positive RT-PCR result was 3.4 days. Six patients (13.0%) were asymptomatic throughout, whereas 40 (87.0%) had at least one symptom prior to hospitalization. The most commonly reported symptoms were fever (65.2%), sore throat (39.1%) and cough (37.0%). In terms of severity of symptoms, the majority of patients experienced mild symptoms (Group 2, 52.2%). Two patients (4.3%) with multiple comorbidities had severe disease requiring ICU admission and mechanical ventilation. There were no mortalities, and the longest staying patient was hospitalized for 18 days. The high rates of infectivity among HCW in HTI can be attributed to working in close proximity while in the asymptomatic incubation phase, while no HCW directly involved in the care of COVID-19 positive patients were tested positive. CONCLUSION: We report that HCW share similar clinical characteristics of COVID-19 infection as those of non HCW patients in earlier studies. The infection can spread rapidly within healthcare settings via close contacts among infected HCWs. As such, we advocate distancing when working and usage of personal protective equipment when treating patients with respiratory illness to reduce transmission of COVID-19.


Assuntos
/diagnóstico , Exposição Ocupacional , Recursos Humanos em Hospital/estatística & dados numéricos , Adulto , Infecções Assintomáticas , /transmissão , Comorbidade , Tosse/virologia , Cuidados Críticos/estatística & dados numéricos , Feminino , Febre/virologia , Hospitais de Distrito , Humanos , Tempo de Internação/estatística & dados numéricos , Malásia/epidemiologia , Masculino , Pessoa de Meia-Idade , Gravidade do Paciente , Faringite/virologia , Sintomas Prodrômicos , Estudos Retrospectivos , Fatores de Tempo
19.
Crit Care Med ; 49(3): 428-436, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33512941

RESUMO

OBJECTIVES: Critical care workers were considered to be at high risk of severe acute respiratory syndrome coronavirus-2 infection from patients during the first wave of the pandemic. Staff symptoms, previous swab testing, and antibody prevalence were correlated with patient admissions to investigate this assumption. DESIGN: Cross-sectional study. SETTING: A large critical care department in a tertiary-care teaching hospital in London, United Kingdom. SUBJECTS: Staff working in critical care. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Participants completed a questionnaire and provided a serum sample for severe acute respiratory syndrome coronavirus-2 antibody testing over a 3-day period in April 2020. We compared the timing of symptoms in staff to the coronavirus disease 2019 patient admissions to critical care. We also identified factors associated with antibody detection. Of 625 staff 384 (61.4%) reported previous symptoms and 124 (19.8%) had sent a swab for testing. Severe acute respiratory syndrome coronavirus-2 infection had been confirmed in 37 of those swabbed (29.8%). Overall, 21% (131/625) had detectable severe acute respiratory syndrome coronavirus-2 antibody, of whom 9.9% (13/131) had been asymptomatic. The peak onset of symptoms among staff occurred 2 weeks before the peak in coronavirus disease 2019 patient admissions. Staff who worked in multiple departments across the hospital were more likely to be seropositive. Staff with a symptomatic household contact were also more likely to be seropositive at 31.3%, compared with 16.2% in those without (p < 0.0001). CONCLUSIONS: Staff who developed coronavirus disease 2019 were less likely to have caught it from their patients in critical care. Other staff, other areas of the hospital, and the wider community are more likely sources of infection. These findings indicate that personal protective equipment was effective at preventing transmission from patients. However, staff also need to maintain protective measures away from the bedside.


Assuntos
/diagnóstico , Cuidados Críticos , Pessoal de Saúde/estatística & dados numéricos , Recursos Humanos em Hospital/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Humanos , Londres/epidemiologia , Masculino , Pessoa de Meia-Idade , Admissão do Paciente , Centros de Atenção Terciária , Reino Unido/epidemiologia
20.
J Psychiatr Res ; 135: 289-293, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33516081

RESUMO

OBJECTIVE: Mental health professionals are often exposed to workplace violence (WPV) in China. This study examined the prevalence of WPV and the associated factors and quality of life (QOL) among frontline mental health professionals during the COVID-19 pandemic. METHODS: This national survey was carried out between March 15 and March 20, 2020. WPV and QOL were assessed with standardized measures. RESULTS: A total of 10,516 participants were included. The prevalence of overall WPV was 18.5% (95% CI: 17.9%-19.3%), while verbal abuse/threats was 15.8% and physical violence was 8.4%. Multiple logistic regression analysis revealed that male gender (OR = 1.42, p < 0.01), higher educational level (OR = 1.40, p < 0.01), working in tertiary hospitals (OR = 1.33, p < 0.01), caring for COVID-19 patients (OR = 3.10, p < 0.01) and having more severe anxiety symptom (OR = 1.21, p < 0.01) were positively associated with WPV. In contrast, working in inpatient departments (OR = 0.74, p < 0.01), having longer work experience (OR = 0.99, p = 0.03), and being a junior nurse (OR = 0.73, p < 0.01) were negatively associated with WPV. After controlling for the covariates, mental health professionals who experienced WPV had a lower overall QOL compared to those without WPV (F(1, 10515) = 68.28, p < 0.01). CONCLUSION: This study found that WPV was common among mental health professionals in China during the COVID-19 pandemic. Considering the negative impact of WPV on QOL and quality of patient care, appropriate measures to prevent WPV should be developed.


Assuntos
Pessoal de Saúde/estatística & dados numéricos , Serviços de Saúde Mental/estatística & dados numéricos , Qualidade de Vida , Violência no Trabalho/estatística & dados numéricos , Adulto , China/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recursos Humanos em Hospital/estatística & dados numéricos , Prevalência
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