Implementation of a COVID-19 Closed/Open POD Partnership: A Creative Professional Practice Exemplar for Occupational and Environmental Health Nurses.

BACKGROUND: For more than 15 years, the U.S. Centers for Disease Control and Prevention has recommended that all community agencies and workplace environments create structured communication and collaborative plans for emergency or disaster events (2008). This recommendation is aligned with the U.S. Department of Homeland Security's (2022) National Infrastructure Protection Plan. The Coronavirus Disease 2019 (COVID-19) pandemic ultimately demonstrated the importance of having organized plans and processes in place for the effective and rapid dispensing of medical countermeasures (MCMs) to the general populace. Occupational and environmental health nurses (OHNs) can utilize examples of successful MCM dispensing programs and adjust details to fit individual organizational needs. METHODS: This report examines a closed point of dispensing (Closed POD) mass vaccination program as a guide for designing successful workplace partnerships. FINDINGS: Closed PODs are public or private sites that have set up a memorandum of understanding (MOU) with local health authorities to dispense MCMs to their populations during a public health emergency. The desired outcome of a closed POD agreement is the facilitation of employee health and safety, as well as enabling workplace continuity of operations. CONCLUSIONS/APPLICATIONS TO PRACTICE: OHNs will play a pivotal role in any future disaster or emergency event. Because OHNs understand the critical need for anticipatory planning, they are in a prime position to drive the creation and implementation of a closed POD partnership between their workplace and their local health department.

A retrospective study of variations in the kinds of diseases discharged from the Department of Infectious Diseases of a large general hospital in Central China during 2013-2019.

Objective: To analyze the changing trend of the absolute number and constituent ratio of various in-patient diseases in the Department of Infectious Diseases of a large general hospital in Central China during 2013-2019. Methods: A retrospective study was conducted to analyze the diagnostic data of discharged patients for seven consecutive years, from 2013 to 2019. The first discharge diagnosis is used as the basis for the disease classification. The absolute number, constituent ratio, and changing trend of major diseases in hepatobiliary diseases and infectious diseases were analyzed. Results: The changing trend of the diseases during 2013-2019 showed that the absolute number of cases of hepatobiliary disease did not change significantly (p = 0.615), while the constituent ratio decreased significantly, from 68.01% in 2013 to 55.29% in 2019 (p<0.001). The absolute number (constituent ratio) of cases of infectious diseases increased significantly from 585 (21.91%) in 2013 to 1,244 (36.86%) in 2019 (p = 0.015, p<0.001). The major part of the increase was non-communicable infectious diseases (NCIDs). Conclusion: During 2013-2019, the proportion of cases of hepatobiliary disease gradually decreased. The absolute number and proportion of cases of infectious diseases, especially NCIDs, have increased rapidly.

Disinfection of flexible fibre-optic endoscopes out-of-hours: confidential telephone survey of ENT units in England - 20 years on.

BACKGROUND: Flexible upper aerodigestive endoscopy is often performed in the emergency setting. To prevent nosocomial infection on-call clinicians must have access to decontaminated endoscopes. METHODS: A telephone survey of 104 ENT units in England replicated previous cycles conducted 10 and 20 years ago. The on-call clinician was asked about decontamination practices, training and cross-cover. RESULTS: Seventy-one clinicians participated of which 68 had an endoscope available out-of-hours. Twenty-five (36.8 per cent) used single-use endoscopes. Twenty-three (51.1 per cent) of the 45 clinicians using re-usable endoscopes decontaminated them themselves, an increase from 43.3 per cent in 2013 and from 35.1 per cent in 2002. Overall 91.2 per cent had safe practices, up from 68.7 per cent in 2013 and 48 per cent in 2002. One hundred per cent had been trained in decontamination, compared to 37.3 per cent in 2013 and 12.1 per cent in 2002. On-call clinicians from the ENT department increased to 91.5 per cent, compared to 63 per cent in 2013. CONCLUSION: There has been a dramatic increase in patient safety, underpinned by the introduction of single-use endoscopes, increased training and reduced cross-cover.

Innovative Cohort Process to Minimize COVID-19 Infection for Migrant Farmworkers During Travel to Iowa.

Background: Migrant and seasonal farmworkers (MSFW) experience disproportionate infection, severe disease and death from COVID-19. This report describes an innovative process to address the safety of MSFW that utilized cohorting that eventually allowed for safe release to work in the fields on a large family farm in Iowa. Methods: Upon worker departure from Mexico, the employer arranged for bus seat assignments, mask use, and hand hygiene practice during the 3-day trip to Iowa. Upon arrival at the farm, surveillance testing and low-density housing cohorting based upon travel seat assignments allowed for early identification of infected workers and appropriate quarantine as per CDC guidelines. Upon completion of isolation or quarantine as appropriate, workers were released to congregate housing and work in the fields. Findings: Compared to a migrant farmworker COVID-19 outbreak without travel pre-planning, the cohorting process produced a 3.5% positivity rate compared to an earlier season July farmworker group on the same farm with a 12.7% positivity rate. Conclusions/Application to Practice: The success of this model points to the power of collaboration between farm employer, health care providers and workers to minimize worker infection and enable safe work in the fields. Increased state and federal support for MSFW protections could support infrastructure to proactively plan for prevention mechanisms to prevent the spread of known communicable disease. With support in place from the top down, employers, workers, and health care providers will be able to prioritize the management of infectious diseases and the needs of essential workers.

Prevalence of SARS-CoV-2 IgG/IgM Antibodies among Danish and Swedish Falck Emergency and Non-Emergency Healthcare Workers.

BACKGROUND: Knowledge about the COVID-19 outbreak is still sparse, especially in a cross-national setting. COVID-19 is caused by a SARS-CoV-2 infection. The aim of the study is to contribute to the surveillance of the pandemic by bringing new knowledge about SARS-CoV-2 seropositivity among healthcare workers. It seeks to evaluate whether certain job functions are associated with a higher risk of being infected and to clarify if such association is mediated by the number of individuals that employees meet during a workday. In addition, we investigate regional and national differences in seroprevalence. METHODS: This research involved a bi-national prospective observational cohort study including 3272 adults employed at Falck in Sweden and Denmark. Participants were tested for SARS-CoV-2 antibodies every second week for a period of 8 weeks from 22 June 2020 until 10 August 2020. Descriptive statistics as well as multivariable logistic regression analyses were applied. RESULTS: Of the 3272 Falck employees participating in this study, 159 (4.9%) tested positive for SARS-CoV-2 antibodies. The seroprevalence was lower among Danish Falck employees than among those from Sweden (2.8% in Denmark and 8.3% in Sweden). We also found that the number of customer or patient contacts during a workday was the most prominent predictor for seropositivity and that ambulance staff was the most vulnerable staff group. CONCLUSION: Our study presents geographical variations in seroprevalence within the Falck organization and shows evidence that social interaction is one of the biggest risk factors for becoming infected with SARS-CoV-2.