ABSTRACT
Objectives: To describe the lived experience of healthcare staff during the Coronavirus Disease 2019 (COVID-19) pandemic relating to the use of personal protective equipment (PPE) and investigate risks associated with PPE use, error mitigation and acceptability of mindfulness incorporation into PPE practice. Methods: A qualitative human factors' study at two Irish hospitals occurred in late 2020. Data was collected by semi-structured interview and included role description, pre-COVID-19 PPE experience, the impact of COVID-19 on lived experience, risks associated with PPE use, contributory factors to errors, error mitigation strategies and acceptability of incorporating mindfulness into PPE practice. Results: Of 45 participants, 23 of whom were nursing staff (51%), 34 (76%) had previously worn PPE and 25 (56%) used a buddy system. COVID-19 lived experience impacted most on social life/home-work interface (n=36, 80%). Nineteen staff (42%) described mental health impacts. The most cited risk concerned 'knowledge of procedures' (n=18, 40%). Contributory factors to PPE errors included time (n=15, 43%) and staffing pressures (n=10, 29%). Mitigation interventions included training/education (n=12, 40%). The majority (n=35, 78%) supported mindfulness integration into PPE practice. Conclusions: PPE training should address healthcare staff lived experiences and consider incorporation of mindfulness and key organisational factors contributing to safety.
ABSTRACT
Background and Aim Clostridioides difficile infection (CDI) is the leading cause of hospitalacquired infectious diarrhoea. High bed occupancy rates in acute hospitals correlate with an increased incidence of healthcare-associated CDI (HA-CDI). The COVID-19 pandemic led to changes within our healthcare system, including cessation of elective procedures and reduced presentations for non-COVID-19-related illnesses. Our aim was to determine if improved hand-hygiene, increased use of personal protective equipment (PPE), social distancing and reduced hospital occupancy observed during the first wave of the COVID-19 pandemic also impacted on rates of HA-CDI. Methods: We defined the COVID-19 outbreak period as March to May 2020 and identified newly-acquired HA-CDI cases during the same periods in 2018, 2019 and 2020, using the hospital C. difficile database. HA-CDI was defined as per national case definitions. Electronic records were used to assess patient demographics and biochemical markers. Hospital antimicrobial consumption and hand-hygiene audit data for the study period and corresponding in 2018, 2019 and 2020 were collected. Statistical analysis was performed using STATA. Results Fifty patients with HA-CDI were identified. Chi-squared analysis with Yates correction demonstrated a decrease in newly-acquired HACDI during the first wave of the COVID-19 pandemic period when compared to the same period in 2018 and 2019 (p=0.029);(Table 1). Conclusion During the first wave of the COVID-19 pandemic, static antimicrobial use, reduced hospital occupancy, improved hand hygiene and the use of PPE resulted in a decline in HA-CDI;demonstrating the importance of hospital activity and infection prevention and control measures on HA-CDI during an inpatient stay. (Table presented)
ABSTRACT
Introduction: Staff competency and access to PPE training became critical early in the COVID 19 pandemic. This placed demands on infection prevention & control staff when already busy with COVID-19-related tasks. Objectives: To be prepared for the next pandemic, we investigated the role of mindfullness and technology in PPE training. Methods: Human factors research involving three clinical sites (N = 174) consiting of interviews, workshops and participatory codesign sessions. This was extended by interviews with 14 IPC experts from 7 sites in UK and USA. Results: Existing PPE & HH Training: - Addressed the lived experience of using PPE - Variety of training formats e.g. classroom (15%) and in-unit training (85%) - One (1/10) site assessed PPE competency - Four (4/10) sites used a Virtual Learning Environment to track the learner journey - One (1/10) site used a mobile phone based training Performance Shaping Factors: - Training, Fatigue, Distraction, Rushing, Stress, etc. - Changing types of PPE with different quality and fit - Changing PPE guidelines as IPC knowledge evolved Emerging Mobile Learning App Concept & Requirements: - All trainers expressed concerns of low engagement with phonebased training - Online and in-person training must be consistent - Assessment should be carried out on-site, with special-purpose equipment - PPE and Hand Hygiene training should incorporate self-care & mindfulness - Scenario-based training needed to support different clinical roles and needs - Customise training to local guidelines Conclusion: Mindfulness is a protective factor for effective and safe performance. Organisations should consider integrating wellness into IPC training. Technology can support in-person training but it is not a replacement and must be available 24-7. A variety of training access pathways are good but the Learner Journey should be tracked to ensure everyone is trained and skills are maintained over time.
ABSTRACT
Presentation A 40-year-old healthcare worker (HCW) presented with cough, headache, sore throat, fatigue and myalgia seven months after primary infection with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Symptoms were milder and recovery was faster on the second episode. Diagnosis Reinfection with phylogenetically distinct SARS-CoV-2 was confirmed by whole-genome sequencing (WGS). Treatment Management involved symptomatic treatment and self-isolation. Discussion The incidence of SARS-CoV-2 reinfection is not well characterised. Infection control precautions may still be required in healthcare facilities, even in previously infected and possibly in vaccinated individuals while SARS-CoV-2 remains in circulation. Further research on the nature and duration of immunity is required to inform public health and infection control policy.