ABSTRACT
Introduction: Since the beginning of the COVID-19 pandemic, HUG are taking care of patients suspected of having or affected with COVID- 19. The majority of the HUG wards became COVID wards;CONTACT and DROPLETS measures replaced SP. When the situation returned to normal, the use of personal protective equipment was inappropriate. A corrective program was implemented. One of its objectives was to address the role of the MED/NURS leaders of the non-COVID wards. In the initial phase of the program, the PCI knowledge of these managers was assessed and updated. The majority of the wards became COVID wards;CONTACT and DROPLETS measures replaced SP. Objectives: To assess the knowledge of MED/NURS leaders of non- COVID wards regarding hand hygiene and wearing of gloves and to evaluate the choice of personal protective equipment by MED/NURS managers in non-COVID wards for frequent clinical situations. Methods: The MED/NURS managers of the non-COVID wards were invited to participate in a training session. 3 ICP professionals and 1 adult education specialist: 1. described the context and presented the project;2.tested the participants' knowledge about hand hygiene, gloves' wearing and personal protective equipment to be used in frequent clinical situations. The quiz was built with an educational purpose. The participants' answers were recorded anonymously by an online survey software. Aggregated responses were presented and commented during the session. Results: 11 training sessions were held from 27.01.2021 to 26.02.2021;286 MED/NURS leaders were invited: 177 (61.8%) attended. More than 75% of the participants appreciated this type of training. Conclusion: Knowledge about hand hygiene and gloves' wearing is satisfactory: it was enough to answer true or false to a statement. The percentage of correct answers given to clinical situations is insufficient: knowing which personal protective equipment to use with regard on transmission risk remains complicated. This is one of the topics on which our program must focus.
ABSTRACT
Introduction: Since the beginning of the COVID-19 pandemic, HUG hospital is mandated to care for patients suspected of having or affected by COVID-19. The majority of the wards (W) at HUG became COVID W;CONTACT and DOPLETS measures replaced standard precautions (SP). Additional measures were implemented to prevent nosocomial (NOSO) cases: control of visitors and staff at the entrance of the hospital, surgical mask wearing, screening of patients and staff, epidemiological surveillance. Vaccination started in January 2021. On 26.05.2021, 17.3% of the general population and 57.5% of the hospital staff received at least one dose. Objectives: To reduce the occurrence of NOSO cases in non-COVID W Methods: The program covers the period from 01.01 to 30.06.2021 and concerns non-COVID units. It is based on several axes of intervention, including: 1.Training: medical-nursing managers of the non-COVID W were invited to participate in a training session on the topic “SP”. Trainers were 3 IPC professionals and 1 adult education specialist. 2. Monitoring of compliance with hand hygiene, mask wearing and provision of alcohol based handrub at the W entrance. Observers are trained, validated and interrater reliability tested. Feedback was applied: oral immediate feedback;monthly delayed feedback using a poster for each W with SP' compliance, explaining the results with the hierarchy, and set the goal for next month. A written report was sent to the hospital management. Patients' data are from the prospective national surveillance on COVID-19 identified hospitalized COVID-19 adult cases with a laboratory confirmed infection. NOSO cases were defined as those detected > 5 days after hospital admission. Results: From 24.08.2020 to 23.05.2021, 1863 community acquired COVID cases and 497 NOSO cases were collected. The percentage of NOSO cases decreased after the introduction of the program (before 426/1589 (26.8%) after 71/771 (9.2%), p < 0.001). Conclusion: Following the intervention, the incidence of NOSO cases has markedly decreased.
ABSTRACT
Introduction: Since the beginning of the COVID-19 pandemic, HUG took care of a large number of patients suspected of having or affected by COVID;the majority of HUG wards became temporarily COVID wards. When the situation returned to normal, the practice of SP needed to be strengthened. Among SP, HH is the most important. Monitoring HH by direct observation (DO) and performance feedback are essential to improve and sustain compliance. Glove use remains a challenge for HH compliance, particularly before donning or after doffing. Immediate individual feedback (IIF) is very useful for the understanding of HH by HCWs during patient care. Objectives: To evaluate HH compliance improvement when immediate or delayed feedback is provided and to assess the impact of glove use on compliance. Methods: The study was conducted at HUG from 1 January to 30 June 2021. Trained, validated and interrater reliability-tested observers monitored HH using the WHO DO method, for a minimum of 30 opportunities/ ward/month. Feedback were applied using a series of approaches: immediate oral individual feedback (IIF) to HCW, a monthly delayed feedback by the IPC nurse through a poster figuring the average ward compliance observed and goal setting for the next month. A written report of HH compliance including the rate of missed actions while the HCW was wearing gloves was also provided. Final results for the total study period with statistical evaluation will be provided at ICPIC. Results: Between 1 Jan and 30 April 2021, a total of 10,332 opportunities were observed. Table 1 shows preliminary results of overall monthly HH compliance, levels of IIF and frequencies of missed HH actions in the presence of gloves. Conclusion: The intervention was associated with improvement in HH compliance. Glove use was associated with a high number of missed HH actions. Reduction of glove use together with individual feedback were associated with a decreased frequency of missed actions.
ABSTRACT
OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic has caused major sanitary crisis worldwide. Half of the world has been placed in quarantine. In France, this large-scale health crisis urgently triggered the restructuring and reorganization of health service delivery to support emergency services, medical intensive care units and continuing care units. Health professionals mobilized all their resources to provide emergency aid in a general climate of uncertainty. Concerns about the mental health, psychological adjustment, and recovery of health care workers treating and caring for patients with COVID-19 are now arising. The goal of the present article is to provide up-to-date information on potential mental health risks associated with exposure of health professionals to the COVID-19 pandemic. METHODS: Authors performed a narrative review identifying relevant results in the scientific and medical literature considering previous epidemics of 2003 (SARS-CoV-1) and 2009 (H1N1) with the more recent data about the COVID-19 pandemic. We highlighted most relevant data concerning the disease characteristics, the organizational factors and personal factors that may contribute to developing psychological distress and other mental health symptoms. RESULTS: The disease characteristics of the current COVID-19 pandemic provoked a generalized climate of wariness and uncertainty, particularly among health professionals, due to a range of causes such as the rapid spread of COVID-19, the severity of symptoms it can cause in a segment of infected individuals, the lack of knowledge of the disease, and deaths among health professionals. Stress may also be caused by organizational factors, such as depletion of personal protection equipment, concerns about not being able to provide competent care if deployed to new area, concerns about rapidly changing information, lack of access to up-to-date information and communication, lack of specific drugs, the shortage of ventilators and intensive care unit beds necessary to care for the surge of critically ill patients, and significant change in their daily social and family life. Further risk factors have been identified, including feelings of being inadequately supported, concerns about health of self, fear of taking home infection to family members or others, and not having rapid access to testing through occupational health if needed, being isolated, feelings of uncertainty and social stigmatization, overwhelming workload, or insecure attachment. Additionally, we discussed positive social and organizational factors that contribute to enhance resilience in the face of the pandemic. There is a consensus in all the relevant literature that health care professionals are at an increased risk of high levels of stress, anxiety, depression, burnout, addiction and post-traumatic stress disorder, which could have long-term psychological implications. CONCLUSIONS: In the long run, this tragic health crisis should significantly enhance our understanding of the mental health risk factors among the health care professionals facing the COVID-19 pandemic. Reporting information such as this is essential to plan future prevention strategies. Protecting health care professionals is indeed an important component of public health measures to address large-scale health crisis. Thus, interventions to promote mental well-being in health care professionals exposed to COVID-19 need to be immediately implemented, and to strengthen prevention and response strategies by training health care professionals on mental help and crisis management.