Knowledge, attitude, and practice about airborne infection control guidelines: A crosssectional study among residents doctors of tertiary care hospital in central India

Background: Adherence to National Airborne Infection Control Guidelines (NAIC) by healthcare facilities is an effective way of reducing the spread of air-borne infections such as H1N1, drug-resistant tuberculosis, and COVID-19 disease. Aims and Objectives: This study aims to assess the gaps in knowledge, attitude, implementation, and satisfaction regarding resources availability of NAIC among postgraduate resident doctors. Materials and Methods: Across-sectional study was conducted from December 2019 to February 2021 at a medical college in central India. Total 301 interns, postgraduates, and senior residents in surgery and medicine allied clinical departments were included by convenient sampling method. A pre-designed, self-administered questionnaire was used to assess knowledge, attitude, and practice (KAP) and their satisfaction with available resources regarding NAIC. The data collected were tabulated and were analyzed using descriptive test and comparison of means by Analysis of variance test. Results: Almost 95%, 77%, and 74% of study participants were having adequate KAP on NAIC, respectively. Sixty-one percent participants were satisfied with the resources availability in their work area. Statistically significant association was observed between participants age, designation with their KAP score (P<0.05) and between gender and essential resources provided in the hospital. There was an existence of difference between study participants mean KAP score and essential resources score with statistically significance (P<0.05). Conclusion: The overall KAP was adequate, but there was a gap that exists between knowledge, practice, and satisfaction for availability of essential resources. The study findings were useful for healthcare workers in designing interventions to improve the adherence toward the NAIC guidelines and also to benchmark evaluation of interventions. [ FROM AUTHOR] Copyright of Asian Journal of Medical Sciences is the property of Manipal Colleges of Medical Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Rapid reinfection with SARS-CoV-2 variant-of-concern Alpha detected in a nurse during an outbreak at a non-covid inpatient ward: lessons learned.

We describe the lessons learned during a SARS-CoV-2 variant-of-concern Alpha outbreak investigation at a normal care unit in a university hospital in Amsterdam in December 2020. The outbreak consisted of nine nurses and two roomed-in patient family members. (attack rate 18%). One nurse tested positive with a phylogenetically distinct variant, after a documented infection 83 days prior. Three key points were taken from this investigation. First, it was controlled by adherence to existing guidelines, despite increased transmissibility of the variant. Second, viral sequencing can inform transmission cluster inference, but the epidemiological context is essential to draw appropriate conclusions. Third, reinfections with Alpha variants can occur rapidly after primary infection.

Development and validation of a tool to appraise guidelines on SARS-CoV-2 infection control strategies in healthcare workers.

BACKGROUND: Clinical guidelines on infection control strategies in healthcare workers (HCWs) play an important role in protecting them during the severe acute respiratory syndrome coronavirus 2 pandemic. Poorly constructed guidelines that are incomprehensive and/or ambiguous may compromise HCWs' safety. OBJECTIVE: The objective of this study was to develop and validate a tool to appraise guidelines on infection control strategies in HCWs based on the guidelines published early in the coronavirus disease 2019 pandemic. DESIGN, SETTING, AND OUTCOMES: A three-stage, web-based, Delphi consensus-building process among a panel of diverse HCWs and healthcare managers was performed. The tool was validated by appraising 40 international, specialty-specific, and procedure-specific guidelines along with national guidelines from countries with a wide range of gross national income. RESULTS: Overall consensus (≥75%) was reached at the end of three rounds for all six domains included in the tool. The Delphi panel recommended an ideal infection control guideline should encompass six domains: general characteristics (domain 1), engineering recommendations (domain 2), personal protective equipment (PPE) use (domain 3), and administrative aspects (domain 4-6) of infection control. The appraisal tool performed well across the six domains, and the inter-rater agreement was excellent for the 40 guidelines. All included guidelines performed relatively better in domains 1-3 than in domains 4-6, and this was more evident in guidelines originating from lower income countries. CONCLUSION: The guideline appraisal tool was robust and easy to use. Engineering recommendations aspects of infection control, administrative measures that promote optimal PPE use, and HCW wellbeing were generally lacking in assessed guidelines. This tool may enable health systems to adopt high-quality HCW infection control guidelines during the severe acute respiratory syndrome coronavirus 2 pandemic and may also provide a framework for future guideline development.

Quality Improvement for Outpatient COVID-19 Infection Control.

Background To stop the spread of COVID-19 in outpatient primary care clinics, infection control strategies were needed including social distancing and masking in Fall 2020. Studies show a significant decrease in COVID-19 transmission when healthcare professionals comply with preventive measures. We tested whether an educational video would improve compliance to infection control behaviors quickly. Objective To improve COVID-19 infection control compliance in clinical staff at an outpatient federally qualified health center (FQHC) family medicine residency clinic with quality improvement (QI) tools.  Methods On-line surveys assessed medical assistants' (MAs), residents', and attending physicians' before and after an educational video intervention to assess knowledge of and compliance with social distancing and masking guidelines. Independent observed compliance assessments before and after the educational video were used to confirm the self-reported compliance.  Results The pre- and post-intervention surveys were completed by 49% (37/76) and 62% (47/76) of participants, respectively. Self-reported knowledge and compliance showed no significant change over time. Observed compliance, however, from pre (n = 667) to post (n = 1132) intervention improved for both masking (p < 0.001) and social distancing (p < 0.001). Conclusion An educational video regarding COVID-19 infection control was effective in improving compliance in an outpatient clinic in an underserved, urban setting. While building these new behavioral habits, however, self-report may not be as accurate as observational assessments. Since this intervention was implemented prior to the COVID-19 fall surge and introduction of mass vaccinations, the educational intervention may have improved behavioral compliance with COVID-19 protocols later in the pandemic.

A mixed-methods sequential explanatory design comparison between COVID-19 infection control guidelines' applicability and their protective value as perceived by Israeli healthcare workers, and healthcare executives' response.

BACKGROUND: Healthcare workers (HCWs) are on the front line of the COVID-19 outbreak, and their constant exposure to infected patients and contaminated surfaces puts them at risk of acquiring and transmitting the infection. Therefore, they must employ protective measures. In practice, HCWs in Israel were not fully prepared for this sudden COVID-19 outbreak. This research aimed to identify and compare: (1) Israeli HCWs' perceptions regarding the official COVID-19 guidelines' applicability and their protective value, and (2) HCWs executives' response to HWCs' concern regarding personal protective equipment (PPE) shortage. METHODS: A mixed-methods sequential explanatory design consists of: (1) An online survey of 242 HCWs about the application of the guidelines and PPE, and (2) Personal interviews of 15 HCWs executives regarding PPE shortage and the measures they are taking to address it. RESULTS: A significant difference between the perceived applicability and protective value was found for most of the guidelines. Some of the guidelines were perceived as more applicable than protective (hand hygiene, signage at entrance, alcohol rub sanitizers at entrance, and mask for contact with symptomatic patients). Other were perceived as less applicable than protective (prohibited gathering of over 10 people, maintaining a distance of 2 m', and remote services). CONCLUSIONS: HCWs need the support of the healthcare authorities not only to provide missing equipment, but also to communicate the risk to them. Conveying the information with full transparency, while addressing the uncertainty element and engaging the HCWs in evaluating the guidelines, are critical for establishing trust.