How trainee doctors and nurses react to simulated scenarios of violence against healthcare workers: A cross-sectional study

Medical and nursing students may have to face healthcare-related violence, especially now as they may be doing clinical duty during the Covid-19 pandemic. This study was conducted to analyse the perceptions and attitudes of medical and nursing students towards violence against healthcare workers (HCWs), when presented with audio-visual depiction of simulated scenarios. This cross-sectional study was conducted over a period of six months (April to September 2019) among the undergraduate medical and nursing students of first, second, pre-final and final years making it a total of 800 students. Video clips were shown to the students pertaining to HCWs’ interactions with patients and relatives, and their responses were noted. Among 615 participants who completed the proforma, 248 (40%) students reported having observed or experienced violence in their clinical postings. Overall, 70.7% of medical and 68.5% of nursing students said that they would report incidents of violence to the authority. The questionnaire based on video-based simulated scenarios brought forth the perception that in triggering an act of violence, both the healthcare worker and the attendant could be at fault and full disclosure of complications was a necessary step in preventing such an act of violence. Sensitisation about the same should be incorporated into the teaching curriculum by using simulated scenarios to prepare them to manage such incidents.

Study of immunogenicity, safety and efficacy of covishield vaccine among health care workers in a tertiary cardiac care centre

Purpose: The pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) might be curtailed by vaccination. We assessed the safety, and immunogenicity of Covishield vaccine among Health care workers (HCWs) in a tertiary cardiac care centre. Methods: It's a prospective analytical study, conducted at Sri Jayadeva Institute of cardiovascular science and research centre, Mysore, between January 2021 to May 2021. Pre and Post vaccination SARS CoV2 IgG antibodies were assessed among 122 HCWs. Interval between two doses in this study were 4 and 6 weeks. Adverse events following immunisation b(AEFI) and efficacy were assessed and followed up for two month post vaccination. Results: Post vaccination seropositivity was 69.67% in overall study participants. Seropositivity and P/N ratio median value in uninfected and infected group were 60.43% (n ¼ 55),3.47 (IQR: 2.56–5.22) and 96.77% (n ¼ 30),9.49 (IQR: 7.57–12.30) respectively (P < 0.001). Seropositivity and P/N ratio after 4 and 6 weeks were 48.3% (n ¼ 60), 2.95 (IQR: 1.91–4.24), and 83.8% (n ¼ 31), 4.88, (IQR: 3.39–6.43) respectively (P < 0.001). AEFI after first and second dose was 72.9% and 27.8% (p < 0.05) respectively. The most common symptoms after both doses of vaccination were local pain (73% & 88.2%), followed by fever (38.2% & 26.5%). The average duration of symptoms in both doses was 1.75 days. Of 122 participants only 10 (8.19%) had breakthrough infection after two doses of vaccination with mild severity. Conclusion: Covishield vaccine has showed seropositivity of 69.67%.It has acceptable level of safety profile. Seropositivity and P/N ratio has increased with increase in interval between two doses. Though it has not prevented breakthrough infection it has certainly reduced the severity of infection.

Are the COVID Warriors Confident about COVID Vaccine? A Survey among the Healthcare Workers of West Bengal to Explore their Perception about COVID-19 Vaccine and causes of Vaccine Hesitancy

Introduction : Deaths of Healthcare Workers (HCWs) from COVID-19 infection were reported from various parts of West Bengal months after rolling out of Vaccines for them. Empirical data suggested that those HCWs who died due to COVID- 19 were either not vaccinated or partially vaccinated. which points to Vaccine hesitancy among them. Objectives : (1) To study the perception of HCWs of West Bengal about COVID-19 Vaccine. (2) To determine the level of vaccine hesitancy and its causes among the study population. Methods : A cross sectional exploratory survey was conducted on 400 HCWs. A prevalidated questionnaire was administered which contained questions on profile of the study population, perception about COVID-19 Vaccine, Vaccine hesitancy. Results : 70% of the study population were nurses and only 13% were trained in COVID-19 Vaccination. 44% chose Mask as the most effective strategy to prevent COVID infection followed by Vaccination (36%), social distancing and sanitization. 37% HCWss were hesitant to take Vaccine when offered. Causes of Vaccine hesitancy as admitted by the study population - doubts about Vaccine effectiveness (56%), concern about side effects (30%), difficulty in availability of Vaccine (9%) and confusion about Vaccination strategy (5%). Conclusion : Vaccine confidence among HCWs can inspire the general public for a better coverage of Vaccine among all. The findings of this study will help the program managers to effectively plan strategies to enhance risk perception and Vaccine confidence among General Public.

Prevalence of insomnia and anxiety among healthcare workers during the COVID-19 pandemic in Jilin Province

The outbreak of the 2019 novel coronavirus disease (COVID-19) has impacted the mental health of healthcare providers at the frontline. Therefore, we conducted this study to estimate the prevalence rate of anxiety and insomnia and identify associated risk factors among healthcare workers in Jilin, China, during the period from January 25 to February 25, 2020. Zung's Self-Reported Anxiety Scale (SAS) and the Insomnia Severity Index (ISI) scale were used to diagnose anxiety and insomnia, respectively. Associated risk factors were identified through a multivariate logistic regression model. A total of 300 healthcare workers were invited and 236 completed the study. Of them, 234 (99.15%) were medical workers, 197 (83.47%) were working at frontline departments, and 159 (67.37%) were fighting against COVID-19. Fifty-seven respondents (24.15%) had anxiety (SAS index score ≥45) and 94 (39.83%) had insomnia (ISI score ≥8). Based on the multivariate analysis, contact with people from Hubei province during work (no vs not clear) [OR=0.25, 95%CI: 0.10-0.61] and personal protective equipment (PPE) (not in place vs in place) [OR=6.22, 95%CI: 2.23-17.40] were significantly correlated with anxiety. PPE (not in place vs in place) was the only significant risk factor of insomnia [OR=10.56, 95%CI: 4.00-27.87]. The prevalence of anxiety and insomnia was high in our study, reflecting the psychological impact of COVID-19 on healthcare workers. The unavailability of PPE in place was a significant risk factor of both anxiety and insomnia.

Level of Depression, Anxiety, Stress, and Coping Strategies among Filipino Healthcare Workers (HCW) with Confirmed Covid-19 Infection using the Filipino-translated Depression Anxiety Stress Scale (DASS) 21 and Filipino Coping Strategies Scale in Perpetual Succour Hospital from March 2020 to September 2020: A One-Center Descriptive Study

@#INTRODUCTION: COVID 19 has become the most important public health issue today. It has the potential to significantly affect the mental health of frontline healthcare workers (HCW) putting them at a higher risk of developing psychological problems especially to those who acquired COVID19 infection. OBJECTIVES: To determine the level of depression, stress, anxiety and coping strategies among Filipino HCWs with confirmed COVID-19 infection and its association with demographic and clinical profiles. STUDY DESIGN: Single center Descriptive study materials and methods consisted of 114 Filipino HCW with COVID 19 infection. Data were collected utilizing the Filipino translation of DASS 21 and Filipino Coping Strategy scale. RESULTS: There was a significant increase of HCWs with moderate depression, anxiety, and stress. A large proportion of the HCWs were also severely depressed, severely anxious and severely stress. Majority of the COVID19 positive HCWs were nurses accounting to 35%. More likely, the occupation was significantly associated with their degree of depression and stress. Hypertension associated significantly with elevated stress while having diabetes was instrumental for the depression, anxiety and stress. Moreover, appreciation was more felt at the workplace, then at home. While discrimination was prevalent in the community, workplace and social media. Religiosity ranked the most sought coping strategy. CONCLUSION: The study has found that a large percentage of HCWs had moderate level and a notable portion of respondents had severe to extremely severe level in each of the psychological domains in which factors such as gender, occupation, comorbidities, area of assignment and disease severity have brought significant impact. Discrimination is prevalent in the community and surprisingly in the workplace. In contrast, appreciation was felt more at home and in the workplace. Religiosity was shown to be the top coping strategy among HCWs who tested positive.

Occupational risk factor of health care workers of Hepatitis B infection and its prevention / Монголын Анагаах Ухаан

@#Hepatitis B (HBV) and C (HCV) are viral infections which can cause acute and chronic hepatitis and are the leading causes for hepatic cirrhosis and cancer, thus creating a significant burden to healthcare systems due to the high morbidity/mortality and costs of treatment. The risk of HBV infection in an unvaccinated person from a single HBV-infected needle stick injury ranges from 6–30. The prevention of HBV infection among HCWs has become a crucial issue. HBV can effectively be prevented by vaccination. A safe and effective HBV vaccine has been available since the 1980s and can prevent acute and chronic infection with an estimated effectivity of 95%. In 2017, the São Paulo Declaration on Hepatitis was launched at the World Hepatitis Summit 2017, calling upon governments to include hepatitis B vaccines for HCWs in national immunization programs. The vaccine is 95% effective in preventing infection and its chronic consequences and has an outstanding record of safety and effectiveness. Data on current hepatitis B vaccine coverage among HCWs in Mongolia is scarce. According to Azzaya et al, the protection level of the subjects was 67.2% >100 mIU/ml, 18.8%, 11-100 mIU/mL and 14.1%, 0-10 mIU/mL based on antibody titer level respectively among the vaccinated HCWs at the 2nd Central hospital. Thus, the HBV vaccination among public and private sector HCWs in Mongolia to inform the health authorities about the HCWs HBV vaccination status along with associated problems and challenges for further improving vaccination strategy among HCWs.

Prevalence of Anti-HBcore Total and HBsAg among Health Care Workers in Public Hospitals, White Nile State, Sudan; 2013.

Background: HBV infection is an occupational disease where health care workers (HCW) are at high risk. Aim: To measure the sero-prevalence of Anti-HBcore Total and HBsAg among HCWs in Public Hospitals, White Nile State, Sudan; 2013. Methods: A cross-sectional, hospital- based study was conducted among health care workers in Public Hospitals in White Nile State, Sudan; 2013. A sample of 385 HCWs was selected using two stage cluster sampling. A pre-tested structured questionnaire was used. The HCWs signed the informed consent to fill the questionnaire and to draw 5 ml venous blood sample for HBV tests. Blood samples were investigated for Anti-HBcore Total. Positive blood specimens for Anti-HBcore Total were further investigated for HBsAg. Data was processed using statistical package for social sciences (SPSS), version 16. Descriptive statistics and non-parametric Z test for single proportion was used at 95% CL. Results: Out of 385 HCWs, 230 (60%) were positive for Anti-HBcore Total. Out of 230 HCWs, 62 (27%) were positive for HBsAg. Prevalence for Anti-HBcore Total and HBsAg is significantly different from the expected values, P=0.001 Conclusion: Sero-prevalence of Anti-HBcore Total and HBsAg is high among HCWs in Public Hospitals in White Nile State, Sudan.

High level of MRSA colonization in health care worker: alarm to implement health care policy.

The aim of the study was to investigate probable carrier rate of the healthcare workers and screened for carriers of MRSA as they could pose a potential risk factor for nosocomial transmission when the same carrier are exposed to the hospital setting during their clinical postings. A total of 100 nasal swabs were collected from the nursing staff and doctors. Sterile cotton swabs moistened with glucose broth were used for sample collection. Swabs were cultured on to nutrient agar, blood agar, and mannitol salt agar, incubated at 35 °C for 48 hrs. Staphylococcus aureus was identified by standard methods according to CLSI guidelines. Methicillin resistance was detected by using cefoxitin disc 30pgm on Mueller Hinton agar with 4% NaCL Of the 100 samples screened 30(30%) strains of Staphylococcus aureus were isolated, out of which 16 (53.33%) were Methicillin resistant Staphylococcus aureus (MRSA) and 14 (46.66%) were methicillin sensitive Staphylococcus aureus (MSSA). The overall carriage rate of methicillin resistant Staphylococcus aureus in our study was 16% with the highest rate being seen among the nursing staff (19.35%) and clinical staff carriage rate was lesser (10.52%) as compared to the nursing staff. Chest department samples showed higher carriage rate (33.33%) followed by pediatrics department (28.57%). The present study revealed that HCWs who have contact with patients are at risk of acquisition and colonization with antimicrobial resistant bacteria especially MRSA. Transient hand colonization is the primary mean of cross transmission. Simply education of HCWs on hygienic measures especially proper hand wash is the key to overcome MRSA infection in ICUs.

A study on awareness, occupational risk perception & level of vaccination against hepatitis-B among medical & nursing students in tertiary care hospital, Hyderabad.

Background: HBV(Hepatitis B Virus) infection is an occupational hazard for health care workers and the risk of acquiring HBV infections depends on the frequency of percutaneous and permucosal exposure to blood or blood-contaminated body fluids. Avoiding occupational blood exposure is primary preventive means for the transmission of HBV. However, the single most effective measure for the prevention of hepatitis B is active immunisation. Methods: A cross-sectional study was carried among 204 medical and nursing students in second year of their course using pre-designed questionnaire comprised of questions which included age, sex, qualification, awareness, occupational risk perception & vaccination against hepatitis B infection. Results: 69.12% of the respondents knew various modes of transmission of hepatitis B. More than half (56.86%) of the respondents knew that HBV infection causes liver cancer. 79.41% of the respondents knew the correct course of action after a needle stick injury. Only 61.27% of the respondents knew that blood soaked cotton and dressings are discarded in yellow coloured bags and that sharps and needles are disposed in white coloured bags. Only 36.46% of medical students & 57.41% of nursing students were completely vaccinated. Conclusion: Considering the long-term consequences of HBV infection, the health of the study population is at risk. Preventive strategies against the diseases, especially vaccination programmes, should be developed and taken aggressively to improve the vaccination coverage among the study population.