Nursing staff and the development of nursing services during the COVID-19 pandemic

The availability of sufficient, efficient nursing staff and the development of nursing services are crucial in the provision of high-quality care to healthcare services users. Provision of adequate nursing staff is of vital importance as it affects patient outcomes and safety. Limited nursing staff and a low ratio of nurses per patient are associated with an increased risk of patient death. Understaffing affects the staff members themselves, the patients and the health-care organizations, and, internationally, measures focusing on setting a safe nurse-to-patient ratio have been developed. Factors that increase the need for nursing staff are the increasingly demanding nursing care of patients in hospitals following advances in technology, the ageing of the population, and the increasing numbers of patients and their comorbidities. The COVID-19 pandemic constitutes a new significant determinant of increase in the need for qualified nursing staff. The COVID-19 pandemic has caused major organizational issues in healthcare systems world-wide, even in the developed countries with their reasonably well-organized primary and secondary healthcare systems. Staffing plans during the COVID-19 pandemic should focus on the care needs of patients with COVID-19, and should include the deployment and allocation of skilled clinical staff. Healthcare systems internationally need to take immediate and effective action regarding the availability of qualified nursing staff, to be better prepared for future public health threats.

Stress and coping strategies in the general population of Greece and Cyprus in response to the COVID-19 pandemic: A cross-sectional study

The COVID-19 pandemic and the lockdown policy had a profound psychological impact on the general population worldwide. The aim of this study was to assess the level of stress and coping strategies used during the initial stage of the COVID-19 outbreak and their association. Secondary aims were to a) identify the most important coping strategies and b) investigate predictors of stress. A cross-sectional study was conducted by using an anonymous online questionnaire. The study was carried out from April 23 to May 4 2020. A snowball sampling method was conducted to recruit potential participants from the general population of Greece and Cyprus. Participants over 18 years old who were familiar with the Greek language were included. The psychological impact was assessed by the Impact of Event Scale-Revised (IES-R). Coping strategies were assessed using 15 statements detected from a review of the literature. Participants were asked to rate each one of the coping strategies according to how important it was to them, on a four-point likert scale. The sample consisted of 3941 participants (74.2% women, N=2926), with a mean age of 36.9 years old. The most important coping strategies adopted were 1) "Dealing the situation with a positive attitude” (96.5%), 2) "Follow strict personal protective measures” (95,9%), 3) "Acquiring knowledge about coronavirus” (94.6%), 4) "Engaging in health-promoting behaviors” (89.6%), 5) "Limiting the time spent on media” (75.5%). The highest and positive coefficients were recorded for the association of IES-R scales with 1) "Talking with family and friends to reduce stress”, 2) "Seeking help from a mental health professional”, 3) "Limiting the time spent on media”, 4) "Relieving and managing emotions”, 5) "Practicing relaxation techniques”. 26.5% showed severe psychological impact. Conclusion: Addressing stress levels with the use of functional coping strategies can be beneficial to protect the general population from adverse psychological outcomes. © 2022 Elsevier Masson SAS

Nursing staff and the development of nursing services during the COVID-19 pandemic.

The availability of sufficient, efficient nursing staff and the development of nursing services are crucial in the provision of high quality care to healthcare services users. Provision of adequate nursing staff is of vital importance as it affects patient outcomes and safety. Limited nursing staff and a low ratio of nurses per patient are associated with an increased risk of patient death. Understaffing affects the staff members themselves, the patients and the health-care organizations, and, internationally, measures focusing on setting a safe nurse-to-patient ratio have been devel-oped. Factors that increase the need for nursing staff are the increasingly demanding nursing care of patients in hospitals following advances in technology, the ageing of the population, and the increasing numbers of patients and their co-morbidities. The COVID-19 pandemic constitutes a new significant determinant of increase in the need for qualified nursing staff. The COVID-19 pandemic has caused major organizational issues in healthcare systems world-wide, even in the developed countries with their reasonably well-organized primary and secondary healthcare sys-tems. Staffing plans during the COVID-19 pandemic should focus on the care needs of patients with COVID-19, and should include the deployment and allocation of skilled clinical staff. Healthcare systems internationally need to take immediate and effective action regarding the availability of qualified nursing staff, to be better prepared for future public health threats. Copyright © Athens Medical Society.

Factors Leading People To Undergo A Coronavirus Test: A Retrospective Study In Greece

Background: Early diagnosis and isolation of coronavirus cases contributed to reducing the spread of the pandemic. This can be achieved through systematic population screening with real-time polymerase chain reaction (PCR) test or rapid Sars-Cov-2 antigen test for COVID-19. Objective: The purpose of this study was to highlight the factors that led citizens to carry out a coronavirus test. Methodology: A retrospective study was implemented. The study population consisted of citizens who visited a Primary Healthcare Centre in Northern Greece to undergo a coronavirus test. The data were collected for the period October 2020 to May 2021. Results: The study population included a total of 6,601 people, of which 3,891 people performed PCR tests and 2,710 people performed rapid tests for the coronavirus. Among the people who came for PCR tests, 58.5% were females, while the corresponding percentage in the case of rapid tests was 63.4%. The most common reasons for carrying out PCR tests were case contact (37.3%), fever (35.4%), pharyngitis (11.3%), and anosmia (5.1%). In the case of rapid tests, the most common reasons were screening (38.1%), fever (18.7%), case contact (12.9%), and pharyngeal pain (11.8%). During the autumn and winter months, more people came for PCR tests due to contact with a positive case (40.5%) compared to the spring months (31.1%) (p <0.001). During the autumn and winter months, more people came for rapid tests for precautionary reasons (53.7%) compared to the spring months (29.8%), (p <0.001). People who came for rapid tests due to shortness of breath were older (mean age = 68.2) than the others (p <0.001). Similarly, subjects who underwent PCR tests due to dyspnea were older (mean age = 55.5) than the others (p <0.001). Conclusions: Carrying out a coronavirus screening test is one of the most important measures to control and contain the pandemic, as nowadays, the basic test for the detection of coronavirus is the rapid test, which has significant advantages over the molecular test. © 2022 Surgical Society of Northern Greece. All rights reserved.

Nursing staff and the development of nursing services during the COVID-19 pandemic

The availability of sufficient, efficient nursing staff and the development of nursing services are crucial in the provision of high quality care to healthcare services users. Provision of adequate nursing staff is of vital importance as it affects patient outcomes and safety. Limited nursing staff and a low ratio of nurses per patient are associated with an increased risk of patient death. Understaffing affects the staff members themselves, the patients and the health-care organizations, and, internationally, measures focusing on setting a safe nurse-to-patient ratio have been devel-oped. Factors that increase the need for nursing staff are the increasingly demanding nursing care of patients in hospitals following advances in technology, the ageing of the population, and the increasing numbers of patients and their co-morbidities. The COVID-19 pandemic constitutes a new significant determinant of increase in the need for qualified nursing staff. The COVID-19 pandemic has caused major organizational issues in healthcare systems world-wide, even in the developed countries with their reasonably well-organized primary and secondary healthcare sys-tems. Staffing plans during the COVID-19 pandemic should focus on the care needs of patients with COVID-19, and should include the deployment and allocation of skilled clinical staff. Healthcare systems internationally need to take immediate and effective action regarding the availability of qualified nursing staff, to be better prepared for future public health threats. Copyright © Athens Medical Society.

Attitudes toward COVID-19 Pandemic among Fully Vaccinated Individuals: Evidence from Greece Two Years after the Pandemic

Background:: Considering the major effects of COVID-19 pandemic on health, social, economic, and political dimensions of all countries, positive attitudes toward COVID-19 pandemic are essential to control the pandemic. In our study, we investigated attitudes toward COVID-19 pandemic among fully COVID-19 vaccinated individuals two years after the pandemic and we identified predictors of attitudes. Materials and Methods:: We conducted an on-line cross-sectional study with 815 fully COVID-19 vaccinated individuals in Greece during May 2022. A self-administered and valid questionnaire was disseminated through social media platforms. We measured socio-demographic variables and COVID-19-related variables as potential predictors of attitudes toward COVID-19 pandemic. The outcome variable was attitudes toward COVID-19 pandemic (compliance with hygiene measures, trust in COVID-19 vaccination, fear of COVID-19, and information regarding the COVID-19 pandemic and vaccination). Results:: We found a very high level of compliance with hygiene measures, a high level of trust and information about the COVID-19 pandemic and vaccination, and a moderate level of fear of COVID-19. Also, we identified that females, participants with a higher educational level, those with a chronic disease, those with a better self-perceived physical health, and those without a previous COVID-19 diagnosis adhered more in hygiene measures. Trust in COVID-19 vaccination was higher among females, older participants, those with a higher educational level, those with a better self-perceived physical health, and those without a previous COVID-19 diagnosis. Moreover, females, older participants, those with a higher educational level, those with a chronic disease, those with a better self-perceived physical health, those that received a flu vaccine in previous season, and those without a previous COVID-19 diagnosis experienced more fear of COVID-19. Finally, level of information regarding COVID-19 pandemic and vaccination was higher for participants with a higher educational level, those without a chronic disease, those with a better self-perceived physical health, and those that received a flu vaccine in previous season. Conclusions:: Understanding predictors of attitudes toward COVID-19 pandemic among fully vaccinated individuals is crucial for developing appropriate public health campaigns in the future. Vaccination should be accompanied by positive attitudes in order to decrease the frequency of negative outcomes of COVID-19, such as hospitalization, complications and mortality.

Stress and coping strategies in the general population of Greece and Cyprus in response to the COVID-19 pandemic: a cross-sectional study

The COVID-19 pandemic and the lockdown policy had a profound psychological impact on the general population worldwide. The aim of this study was to assess the level of stress and coping strategies used during the initial stage of the COVID-19 outbreak and their association. Secondary aims were to a) identify the most important coping strategies and b) investigate predictors of stress. A cross-sectional study was conducted by using an anonymous online questionnaire. The study was carried out from April 23 to May 4 2020. A snowball sampling method was conducted to recruit potential participants from the general population of Greece and Cyprus. Participants over 18 years old who were familiar with the Greek language were included. The psychological impact was assessed by the Impact of Event Scale-Revised (IES-R). Coping strategies were assessed using 15 statements detected from a review of the literature. Participants were asked to rate each one of the coping strategies according to how important it was to them, on a four-point likert scale. The sample consisted of 3941 participants (74.2% women, N=2926), with a mean age of 36.9 years old. The most important coping strategies adopted were 1) “Dealing the situation with a positive attitude” (96.5%), 2) “Follow strict personal protective measures” (95,9%), 3) “Acquiring knowledge about coronavirus” (94.6%), 4) “Engaging in health-promoting behaviors” (89.6%), 5) “Limiting the time spent on media” (75.5%). The highest and positive coefficients were recorded for the association of IES-R scales with 1) “Talking with family and friends to reduce stress”, 2) “Seeking help from a mental health professional”, 3) “Limiting the time spent on media”, 4) “Relieving and managing emotions”, 5) “Practicing relaxation techniques”. 26.5% showed severe psychological impact. Conclusion: Addressing stress levels with the use of functional coping strategies can be beneficial to protect the general population from adverse psychological outcomes.

Capillary-based reverse transcriptase loop-mediated isothermal amplification for cost-effective and rapid point-of-care COVID-19 testing.

As the SARS-CoV-2 pandemic continues to spread, the necessity for rapid, easy diagnostic capabilities could never have been more crucial. With this aim in mind, we have developed a cost-effective and time-saving testing methodology/strategy that implements a sensitive reverse transcriptase loop-mediated amplification (RT-LAMP) assay within narrow, commercially available and cheap, glass capillaries for detection of the SARS-CoV-2 viral RNA. The methodology is compatible with widely used laboratory-based molecular testing protocols and currently available infrastructure. It employs a simple rapid extraction protocol that lyses the virus, releasing sufficient genetic material for amplification. This extracted viral RNA is then amplified using a SARS-CoV-2 RT-LAMP kit, at a constant temperature and the resulting amplified product produces a colour change which can be visually interpreted. This testing protocol, in conjunction with the RT-LAMP assay, has a sensitivity of ∼100 viral copies per reaction of a sample and provides results in a little over 30 min. As the assay is carried out in a water bath, commonly available within most testing laboratories, it eliminates the need for specialised instruments and associated skills. In addition, our testing pathway requires a significantly reduced quantity of reagents per test while providing comparable sensitivity and specificity to the RT-LAMP kit used in this study. While the conventional technique requires 25 µl of reagent, our test only utilises less than half the quantity (10 µl). Thus, with its minimalistic approach, this capillary-based assay could be a promising alternative to the conventional testing, owing to the fact that it can be performed in resource-limited settings, using readily available apparatus, and has the potential of increasing the overall testing capacity, while also reducing the burden on supply chains for mass testing.

Low seropositivity for SARS-CoV-2 antibodies among healthcare workers after the first COVID-19 pandemic wave in Greece.

OBJECTIVES: To estimate the prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seropositivity among healthcare workers (HCWs) in Greece and to identify high-risk groups in healthcare facilities. STUDY DESIGN: The study design used in this study is a nationwide cross-sectional study. METHODS: Data were collected from 1 June to 9 July 2020. HCWs in the Greek National Health System were offered a free SARS-CoV-2 IgG antibody test, regardless of symptoms. RESULTS: Overall, 379 of 57,418 HCWs (0.66%, 95% confidence interval [CI]: 0.59-0.73) were positive for SARS-CoV-2 antibodies. The adjusted overall seroprevalence was 0.43% (95% CI: 0.35-0.51). We found that HCWs in non-reference hospitals for COVID-19 (odds ratio [OR]: 1.81, 95% CI: 1.23-2.64; P = 0.002) and reference hospitals for COVID-19 (OR: 1.66, 95% CI: 1.06-2.58; P = 0.03) were more likely to be seropositive than HCWs in primary care centres. Regarding professions, nurses (OR: 1.45, 95% CI: 1.07-1.98; P = 0.02), physicians (OR: 1.43, 95% CI: 1.06-1.93; P = 0.02), and administrative, cleaning and security staff (OR: 1.50, 95% CI: 1.09-2.06; P = 0.01) had a statistically higher chance of having a positive serology than laboratory employees. CONCLUSIONS: The adjusted overall seroprevalence found in this study indicates a very low prevalence of SARS-CoV-2 among HCWs in Greece. This result is in line with the low incidence of COVID-19 during the first wave of the pandemic and is a direct benefit from the early implementation of lockdown.

Seroprevalence of SARS-CoV-2 antibodies and associated factors in healthcare workers: a systematic review and meta-analysis.

BACKGROUND: Healthcare workers (HCWs) represent a high-risk population for infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). AIM: To determine the seroprevalence of SARS-CoV-2 antibodies among HCWs, and identify the factors associated with this seroprevalence. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were applied for this systematic review and meta-analysis. Databases including PubMed/MEDLINE and preprint services (medRχiv and bioRχiv) were searched from inception to 24th August 2020. FINDINGS: Forty-nine studies including 127,480 HCWs met the inclusion criteria. The estimated overall seroprevalence of SARS-CoV-2 antibodies among HCWs was 8.7% (95% confidence interval 6.7-10.9%). Seroprevalence was higher in studies conducted in North America (12.7%) compared with those conducted in Europe (8.5%), Africa (8.2) and Asia (4%). Meta-regression showed that increased sensitivity of antibody tests was associated with increased seroprevalence. The following factors were associated with seropositivity: male gender; Black, Asian and Hispanic HCWs; work in a coronavirus disease 2019 (COVID-19) unit; patient-related work; front-line HCWs; healthcare assistants; shortage of personal protective equipment; self-reported belief of previous SARS-CoV-2 infection; previous positive polymerase chain reaction test; and household contact with suspected or confirmed cases of COVID-19. CONCLUSION: The seroprevalence of SARS-CoV-2 antibodies among HCWs is high. Excellent adherence to infection prevention and control measures; sufficient and adequate personal protective equipment; and early recognition, identification and isolation of HCWs infected with SARS-CoV-2 are imperative to decrease the risk of SARS-CoV-2 infection.