Assessing changes in stethoscope hygiene during COVID-19: a multi-centre cross-sectional study.

BACKGROUND: The COVID-19 (SARS-CoV-2) pandemic has increased infection control vigilance across several modes of patient contact. However, it is unknown whether hygiene pertaining to stethoscopes, which carry the potential for pathogenic contamination, has also shifted accordingly. AIM: To characterize pandemic-related changes in stethoscope hygiene. METHODS: We surveyed healthcare providers at three major medical centres. Questions quantitatively (Likert scale and frequency) assessed stethoscope hygiene beliefs and practices with two components: before and during COVID-19. Participants were grouped based on performance of optimal stethoscope hygiene (after every patient) before and during COVID-19. Groups were compared using χ2 and analysis of variance (ANOVA). FINDINGS: Of the 515 (10%) who completed the survey, 55 were excluded (N = 460). Optimal hygiene increased from 27.4% to 55.0% (P < 0.001). There were significant increases in Likert scores for all questions pertaining to knowledge of stethoscope contamination (P < 0.001). Belief in stethoscope contamination increased (P < 0.001) despite no change in perceived hygiene education. Resident physicians were less likely compared with attending physicians and nurses to have adopted optimal hygiene during COVID-19 (P < 0.001). CONCLUSION: Despite a positive shift in stethoscope hygiene during COVID-19, optimal hygiene was still only performed by around half of providers. Educational interventions, particularly targeting early-career providers, are encouraged.

DIFFICULTIES RECRUITING VOLUNTARY PARTICIPATION IN EXERCISE FOR MENTAL HEALTH: A WESTERN AUSTRALIAN PERSPECTIVE

Background: Traditional health care delivery has been forced to transform to online or telehealth forums due to COVID-19. Patrons receiving psychological therapies had routines disrupted. In Western Australia, interstate and international borders have remained closed, and social and physical distancing restrictions have begun ease within the state. However, the uncertainty of the COVID-19 pandemic remains ever present. As routine in-person appointments recommenced, encouraging a sense of community and addressing physical health through a free exercise programme were hypothesised to be beneficial. Methods: A complimentary, bodyweight exercise programme was offered alongside psychological treatments in a community-based Psychological Services Centre. The Psychological Services Centre already provides group programmes to tackle common issues like sleep and stress for patrons to access. The inclusion of free classes targeting physical activity was hypothesised to be a wellattended component;however, recruitment appeared to be negatively affected by the global COVID-19 pandemic. Results: To overcome these challenges, the recruitment approach was modified. The psychological services centre structurally changed the forms patrons complete as a new client, adding a box indicating whether they would like to be contacted directly regarding relevant research opportunities. This initiative gathered over 70 patrons of which a total of three participants responded to the direct email. Conclusion: Flexibility in delivery (e.g. time variants, online vs in-person) and providing take-home materials (e.g. programme reminders) are essential for ensuring participant involvement. While requiring more creativity on behalf of the researchers, the additional modes of delivery will undoubtedly be advantageous for the participants.

REFLECTIONS FROM THE PEERSUPPORTED WRITING AND WELLBEING PROGRAMME, WRITE SMARTER FEEL BETTER

Objectives: This provides an overview of a peersupported writing and well-being pilot programme for higher degree by research (HDR) students in Australia. It proposes a 6-month programme is a beneficial service to HDR students that improves not only their productivity and writing confidence but assists with their perceived mental well-being as well. Methods: This approach offers a perspective of the piloted writing and well-being programme for HDR students during the recovery period during the COVID-19 global pandemic. It includes generalised reflections of participation, content and structure alongside future directions and further implementation. Findings: This research includes generalised, anonymous data regarding the success of the writing and well-being pilot programme for HDR students and components to improve upon. It suggests that the overwhelming response from participants was positive, especially during various COVID-19-related lockdowns and travel restriction measures. HDR student participants in a 6-month writing and well-being workshop enthusiastically participated (100% attendance) and anecdotally shared a collective sense of satisfaction and yearning for each session. Finding a place to safely and regularly express concerns, ideas and possible solutions among peers is an identified need to be addressed and a component that can sustainably be facilitated. Conclusion: The success, measured by adherence and well-being improvements, of the Write Smarter: Feel Better programme can influence the way in which universities address and protect mental well-being of their HDR students.

Post-ureteroscopy febrile urinary tract infections are linked to pre-operative stent dwell time: Results from three European endourology centres

Introduction: Indwelling ureteric stents, usually inserted for emergency drainage of an obstructed system, can cause significant morbidity with infections. We aimed to assess pre-operative stent dwell time on infectious complications following ureteroscopy and laser fragmentation (URSL). Material and Methods: Data was retrospectively collected for outcomes of URSL from 3 European endourology centres for patients with pre-operative indwelling ureteric stents. We included data for patient details, stone demographics, operative details, stone free rate (SFR), outcomes and complications between 2011 and 2020. Patients divided into group 1 (<6 months stent dwell time) and group 2 (6 months). Primary outcomes were early post-operative infectious complications (febrile UTI) and ICU access. Analysis with binomial logistic regression (SPSS v.24). Results: 501 patients were included (group 1, n=429;group 2, n=72) [Table 1]. Mean age and operative time in groups 1/2 were 71-30 years and 64-22 years, and 51-28 minutes and 59-31 minutes. Febrile UTI and ICU admissions were seen in 32(8%) and 3(0.7%), and 22(31%) and 1(1.4%) in groups 1/2 respectively. Stent dwell time of 6 months carried significantly higher risk for febrile UTI post URSL (RR=5.45, 95% CI: 2.94-10.10, p<0.001) [see fig 1]. Conclusion: Although the overall risk of infectious complication rates from URSL were low, longer indwelling stent time significantly increases the risk of post-operative infections. We would recommend having the stent dwell time as short as possible and not to exceed 6 months. Our findings will help prioritise these patients in the post-COVID era.

Reflections on COVID -19 and the potential impact on preterm infant feeding and speech, language and communication development

Infants needing the support of a neonatal unit have unique, individual needs that require a Synactive approach to enable effective management of both the environment and the infant themselves (Als, 1986). Parents working in partnership with neonatal colleagues play an essential role in developing competent skills to appraise an infant's function. For parents, learning to care and interact with their infant on a neonatal unit presents unexpected complications including learning to cope and be close to their baby in an unfamiliar setting (Cardin, 2020). The current COVID -19 pandemic has challenged all aspects of neonatal work causing anxiety and stress for all involved in infant care. Neonatal teams have been working together to continue to provide excellent care, and to make adaptations in a difficult and unfamiliar situation. A major change to practice has been the need to limit parent visiting time and access to the cot -side. This is further complicated by the need for practitioner use of face - masks and personal protective equipment when treating infants on neonatal units which has inevitably altered the traditional developmental care approaches undertaken in the UK (Altimier et al., 2015).