RESUMO
Healthcare workers face specific challenges during infectious disease outbreak. Along with fear of getting infection, performing new, unfamiliar tasks in unfamiliar setting with new outfit (PPE) complicates their working. We explore perceptions and lived experiences of front-line nurses who cared for COVI9-19 confirmed patients in a tertiary hospital of North India eighteen in-depth, telephonic, semi structured interviews were conducted. Interviews were transcribed and analysed using Colaizzi’s phenomenological method. Nurses were challenged by risk of infection or fear of transmission, working in a new setting, unfamiliar clinical roles, heavy workloads, ineffective communication and discomforts of protective gear. Despite facing various challenges, nurses showed great strength and resilience. Good administrative support, PPE surveillance, developing nurses’ task force with distinct responsibilities, orientation, training and empowerment are suggested strategies to overcome the challenges and enhance the resilience. Nurses lived experiences will be helpful to healthcare organizations preparing for or responding to outbreaks or disaster.
RESUMO
Background: Blood culture is widely accepted as the gold standard investigation for the diagnosis of blood stream infections (BSI). The number of blood cultures collected has a considerable impact on the organism isolation. This study aims to optimize the number of blood cultures needed, for an optimal diagnostic yield in BacT/ALERT VIRTUO system mainly in a resource limited setting. Methods: All the blood cultures (BCs) obtained in BacT/Alert bottles per patient during a 24-h period were included as ‘one episode’ and categorized as single bottle, 1-set (2 aerobic bottles), 2 sets and 3 sets. BC bottles were incubated in the BacT/ALERT VIRTUO (bioMérieux) for a period of five days. Bottles flagged positive were subjected to Gram staining and culture plating. Colonies grown were identified by MALDI-TOF MS, VITEK MS, bioMérieux. Results: Cumulative positivity rate increased (21.7%, 41.4%, 56.1%, 60.6%) and pathogen isolation rate increased (10.3%, 21.8%, 30.4% and 33.8%) progressively when collected in single bottle, 1, 2 and 3 sets respectively. The pathogen detection rate for GNB and GPC were 45.1% and 42.6% respectively with one bottle and this got upsurged to 85.6% and 98.9% for GNB and 83.6% and 98.2% for GPC when collected in ?1 set and ?2 sets respectively. Conclusions: Two BC sets over a 24-h period can detect approximately 98% of the pathogens with a cumulative positivity rate of 60% and hence it is a justifiable alternative approach to the standard practice of 3-sets of BCs.