Patients' capability, opportunity, motivation, and perception of inpatient hand hygiene.

BACKGROUND: Studies that examine the perceptions and behaviors of patients regarding patient hand hygiene rarely examine the viewpoint of patients about their hand hygiene behavior relative to current resources provided in the hospital. METHODS: Voluntary interviews that employed a 16-item survey tool were used among patients (N = 107) in outpatient clinics at post-admission visits. The survey was created using the Behavior Change Wheel, Capability, Opportunity, Motivation Behavior model. Patients were asked whether they brought hand sanitizer to the hospital, used hospital resources to clean their hands, and their perspective on patient hand hygiene importance compared with hospital staff, as well as their satisfaction or lack of satisfaction with hand hygiene independence. RESULTS: Most of the participants (65, 60.7%) reported that prior to being admitted to the hospital, they were able to maintain cleaning their hands with little or no difficulty. During their admission, only 21 (19.6%) of the participants reported needing little or no assistance. More than one-half of the participants, 34 (31.8%) and 23 (21.5%), respectively, reported, mostly or completely agreeing that the hand hygiene of the health care staff was more important than their own. Close to one-half of the participants (50, 46.7%) reported not being satisfied at all with their ability to maintain their hand hygiene in the hospital, whereas only 10 (9.3%) were very satisfied with their ability to maintain hand hygiene. CONCLUSIONS: Findings from this study will enhance our understanding of how to incorporate inpatient hand hygiene into existing infection control programs in inpatient settings.

Increased Reporting of Sexual Minority Orientation from 2009 to 2017 in England and Implications for Measuring Sexual Minority Health Disparities.

Purpose: Sexual minority adults experience considerable mental and physical health disparities compared to their heterosexual counterparts, but changes in these disparities over time may, in part, reflect changes in how the same people self-identify their sexual orientation. Therefore, we estimated between-cohort and within-person changes in self-identified sexual orientation to better understand changes in sexual orientation-based health disparities over the life course. Methods: We examined 2009 to 2015 changes among 5712 adults 19-25 years of age from the Longitudinal Study of Young People in England (LSYPE) to validate a synthetic cohort approach applied to cross-sectional data on 1,168,346 adults 18-74 years of age (n = 29,677 sexual minority adults) from the General Practice Patient Survey (GPPS), estimating 2009 to 2017 changes in sexual orientation identification. Results: Heterosexual identification for adults 18-24 years of age fell three percentage points from 2009 to 2017. Approximately half of those 26-32 years of age, who identified as sexual minority adults in 2017, may not have identified as such 8 years earlier. LSYPE and GPPS results were similar, validating the synthetic cohort application. Within-cohort analyses estimated that 2.1% and 2.7% of heterosexual-identified women and men 18-24 years of age in 2009, respectively, changed identification by 2017. Smaller changes occurred for adults 25-34 years of age (1.0% and 1.2%, respectively), with still smaller differences at older ages. Conclusion: Changes in health disparities may reflect people newly identifying as a sexual minority as well as longitudinal changes in those long identifying as sexual minority adults. Future research should measure the health of both early- and late-identifying sexual minority adults, as their health care and policy needs may differ.

Otorhinolaryngology Out-Patient Practice in the “Post”-COVID-19 Era: Ensuring a Balance Between Service and Safety

Objective@#To review available resources and provide evidence-based recommendations that may optimize otorhinolaryngologic out-patient health care delivery in the “post”-COVID-19 era while ensuring the safety of our patients, healthcare workers and staff.@*Data Sources@#Relevant peer-reviewed journal articles; task force, organizational and institutional, government and non-government organization recommendations; published guidelines from medical, health-related, and scientific organizations.@*Methods@#A comprehensive review of the literature on the COVID-19 pandemic as it pertained to “post”-COVID 19 out-patient otorhinolaryngologic practice was obtained from peer-reviewed articles, guidelines, recommendations, and statements that were identified through a structured search of the data sources for relevant literature utilizing MEDLINE (through PubMed and PubMed Central PMC), Google (and Google Scholar), HERDIN Plus, the World Health Organization (WHO) Global Health Library, and grey literature including social media (blogs, Twitter, LinkedIn, Facebook). In-patient management (including ORL surgical procedures such as tracheostomy) were excluded. Retrieved material was critically appraised and organized according to five discussion themes: physical office set-up, patient processing, personal protection, procedures, and prevention and health-promotion.@*Conclusion@#These recommendations are consistent with the best available evidence to date, and are globally acceptable while being locally applicable. They address the concerns of otorhinolaryngologists and related specialists about resuming office practice during the “post”-COVID-19 period when strict quarantines are gradually lifted and a transition to the “new” normal is made despite the unavailability of a specific vaccine for SARS-CoV-2. While they target practice settings in the Philippines, they should be useful to ENT (ear, nose & throat) surgeons in other countries in ensuring a balance between service and safety as we continue to serve our patients during these challenging times.