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1.
Sao Paulo Med J ; 138(4): 305-309, 2020.
Article in English | MEDLINE | ID: covidwho-2140943

ABSTRACT

BACKGROUND: The COVID-19 pandemic is threatening healthcare systems and hospital operations on a global scale. Treatment algorithms have changed in general surgery clinics, as in other medical disciplines providing emergency services, with greater changes seen especially in pandemic hospitals. OBJECTIVES: To evaluate the follow-up of patients undergoing emergency surgery in our hospital during the COVID-19 pandemic. DESIGN AND SETTING: Cross-sectional study conducted in a tertiary-level public hospital. METHODS: The emergency surgeries carried out between March 11 and April 2, 2020, in the general surgery clinic of a tertiary-care hospital that has also taken on the functions of a pandemic hospital, were retrospectively examined. RESULTS: A total of 25 patients were included, among whom 20 were discharged without event, one remained in the surgical intensive care unit, two are under follow-up by the surgery service and two died. Upon developing postoperative fever and shortness of breath, two patients underwent thoracic computed tomography (CT), although no characteristics indicating COVID-19 were found. The discharged patients had no COVID-19 positivity at follow-up. CONCLUSION: The data that we obtained were not surgical results from patients with COVID-19 infection. They were the results from emergency surgeries on patients who were not infected with COVID-19 but were in a hospital largely dealing with the pandemic. Analysis on the cases in this study showed that both the patients with emergency surgery and the patients with COVID infection were successfully treated, without influencing each other, through appropriate isolation measures, although managed in the same hospital. In addition, these successful results were supported by 14-day follow-up after discharge.


Subject(s)
Coronavirus Infections , Emergency Medical Services , Pandemics , Pneumonia, Viral , Surgical Procedures, Operative , Betacoronavirus , COVID-19 , Cross-Sectional Studies , Hospitals, Public , Humans , Retrospective Studies , SARS-CoV-2 , Tertiary Care Centers , Turkey
2.
Medwave ; 22(10): e2602, 2022 Nov 09.
Article in English, Spanish | MEDLINE | ID: covidwho-2144875

ABSTRACT

The arrival of the new coronavirus disease (COVID-19) has challenged and exposed the precarization of health systems in the face of pandemic diseases. Medical personnel has demonstrated their commitment to service and workforce force, despite having inadequate medical equipment, supplies, hospital beds, and personnel, not to mention the risk of being victims of this disease. With this article, we aim to share the experience and capabilities of the medical staff to overcome adversities: their resilience and resourcefulness in the face of traumatic situations, and using and modifying any available equipment in the absence of mechanical ventilators to mitigate the progression of the disease.


La llegada de la enfermedad por el nuevo coronavirus (COVID-19) ha desafiado todos los sistemas de salud y puso en evidencia el precario sistema sanitario frente a enfermedades pandémicas. A pesar de esto, el personal médico ha demostrado la vocación de servicio y la fuerza laboral, aunque trabaje con insumos insuficientes, equipos médicos inadecuados, falta de camas de hospitalización, falta de personal y algunos fallezcan víctimas de esta enfermedad. Con este artículo pretendemos difundir las experiencias y la capacidad del personal médico para vencer estas adversidades, la adaptación positiva a estas situaciones traumáticas, utilizar y modificar todas las herramientas disponibles ante la falta de ventiladores mecánicos que lograron mitigar la progresión de la enfermedad.


Subject(s)
COVID-19 , Pandemics , Humans , Peru/epidemiology , Health Personnel , Hospitals, Public
3.
Front Public Health ; 10: 977221, 2022.
Article in English | MEDLINE | ID: covidwho-2142330

ABSTRACT

The epidemic of COVID-19 has a great impact on the life and safety of people around the world. As the main force in the fight against COVID-19, the financial management of public hospitals will provide a strong guarantee for the diagnosis and treatment behavior of medical staff. The financial department needs to recognize the extent of the impact of COVID-19 on hospital finance, quantify and predict the potential risk factors, and develop reasonable financial management strategies. As an important part of assessing the financial health of public hospitals, the capital liquidity can be used as the focus direction of the hospital managers. In this study, we determine the effects of COVID-19 on the finance of public hospitals. Subsequently, we invested the conception, components, risk factors of capital liquidity in public hospitals. In addition, we provided some management strategies of capital liquidity in public hospitals under the epidemic of COVID-19. We deemed that good capital liquidity can ensure that medical staff have enough confidence and mentality to face the risk of death from COVID-19.


Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , Hospitals, Public
4.
Front Public Health ; 10: 957721, 2022.
Article in English | MEDLINE | ID: covidwho-2142321

ABSTRACT

Introduction: Acceptance of COVID-19 vaccination among Health Care Workers is mandatory to lessen and curve the spread of transmission of COVID-19. Even though the Health Belief Model is one of the most widely used models for understanding vaccination behavior against COVID-19 disease, COVID-19 vaccine acceptance among Health Care Workers in Ethiopia was not adequately explored by using the Health Belief Model domains. Purpose: This study aimed to assess COVID-19 vaccine acceptance and associated factors among Health care workers in eastern, Ethiopia. Methods: Institutional-based cross-sectional study design was used among 417 health care workers selected by a systematic random sampling method from June 1- 30/2021. The data were collected by face-to-face interviews using semi-structured questionnaires and analyzed using STATA version 14 statistical software. Multivariable binary logistic regression analysis with a 95% confidence interval was carried out to identify factors associated with willingness to COVID-19 vaccine acceptance and a statistical significance was declared at a P-value < 0.05. Results: The willingness of health care workers to accept the COVID-19 vaccine was 35.6%. Age 30-39 (AOR = 4.16;95% CI: 2.51, 6.88), age ≥ 40 years (AOR = 3.29;95% CI: 1.47, 7.39), good attitude (AOR = 1.97; 95% CI: 1.00, 3.55), perceived susceptibility (AOR = 1.93; 95% CI: 1.12, 3.32), and perceived severity (AOR = 1.78; 95% CI: 1.03, 3.10) were factors significantly associated with Health Care Workers acceptance of COVID-19 vaccine. Conclusion: The willingness to accept the COVID-19 vaccine among HCWs was low. Factors significantly associated with the willingness to accept the COVID-19 vaccine were age, good attitude, perceived susceptibility, and perceived severity of the disease. The low willingness of Health Care Workers to accept the COVID-19 vaccine was alarming and it needs more emphasis from the government in collaboration with other stakeholders to provide reliable information to avert misconceptions and rumors about the vaccine to improve the vaccine status of Health Care Workers to protect the communities.


Subject(s)
COVID-19 , Influenza Vaccines , Influenza, Human , Humans , Adult , COVID-19 Vaccines , Cross-Sectional Studies , COVID-19/prevention & control , Health Knowledge, Attitudes, Practice , Health Personnel , Health Belief Model , Hospitals, Public
6.
Glob Health Sci Pract ; 10(5)2022 10 31.
Article in English | MEDLINE | ID: covidwho-2100394

ABSTRACT

In Rwanda, provider reimbursements for oxygen are based on the duration of patient consumption at a fixed hourly tariff rate. This study sought to assess whether the current insurance tariff in Rwanda was adequate to cover the costs of oxygen used in oxygen therapy and to explore alternative tariff models.The assessment found that hospitals make a marginal surplus from low volume flow rate patients and incur losses from patients who require high volume flow rates. In high volume nonspecialized hospitals with a large pool of patients consuming medical oxygen, low flow rate usage patients (e.g., neonates) tend to subsidize high flow usage patients (surgery), if the number of patients consuming low flow oxygen is higher than the latter. The study found that the current tariff was sufficient before the exponential surge in demand for high flow usage during the peak of the COVID-19 pandemic. A variable tariff that factors both the duration (hours) and the volume (liters) used during the therapy may require more work but better reflects the cost of consumption in each ward. A case-based payment model provides a standard pricing framework based on the patient's diagnosis, intervention, and intensity of treatment.This study highlights the need for a transition from the time-based tariff structure to a case-based or volume-based tariff to incentivize sustainable production and provision (supply) of medical oxygen services at health facilities in Rwanda. Social health insurance reimbursement tariffs for medical oxygen need to reflect both duration and volume of consumption because oxygen therapy varies based on intervention, disease severity, patient age, length of stay, and responsiveness to treatment.


Subject(s)
COVID-19 , Oxygen , Infant, Newborn , Humans , Rwanda/epidemiology , Pandemics , Hospitals, Public
7.
Int J Environ Res Public Health ; 19(21)2022 Oct 28.
Article in English | MEDLINE | ID: covidwho-2090167

ABSTRACT

OBJECTIVE: To analyze COVID-19 deaths in public hospitals in a Brazilian state, stratified by the three waves of the pandemic, and to test their association with socio-clinical variables. METHODS: Observational analytical study, where 5436 deaths by COVID-19 occurred in hospitals of the public network of Espírito Santo, between 1 April 2020, and 31 August 2021, stratified by the three waves of the pandemic, were analyzed. For the bivariate analyses, the Pearson's chi-square, Fisher's Exact or Friedman's tests were performed depending on the Gaussian or non-Gaussian distribution of the data. For the relationship between time from diagnosis to death in each wave, quantile regression was used, and multinomial regression for multiple analyses. RESULTS: The mean time between diagnosis and death was 18.5 days in the first wave, 20.5 days in the second wave, and 21.4 days in the third wave. In the first wave, deaths in public hospitals were associated with the following variables: immunodeficiency, obesity, neoplasia, and origin. In the second wave, deaths were associated with education, O2 saturation < 95%, chronic neurological disease, and origin. In the third wave, deaths were associated with race/color, education, difficulty breathing, nasal or conjunctival congestion, irritability or confusion, adynamia or weakness, chronic cardiovascular disease, neoplasms, and diabetes mellitus. Origin was associated with the outcome in the three waves of the pandemic, in the same way that education was in the second and third waves (p < 0.05). CONCLUSION: The time interval between diagnosis and death can be impacted by several factors, such as: plasticity of the health system, improved clinical management of patients, and the start of vaccination at the end of January 2021, which covered the age group with the higher incidence of deaths. The deaths occurring in public hospitals were associated with socio-clinical characteristics.


Subject(s)
COVID-19 , Pandemics , Humans , COVID-19/epidemiology , Brazil/epidemiology , Hospitals, Public , Incidence
8.
S Afr Med J ; 112(9): 747-752, 2022 08 30.
Article in English | MEDLINE | ID: covidwho-2067142

ABSTRACT

BACKGROUND: Previous studies have reported comorbid disease, including hypertension, diabetes mellitus, chronic cardiac and renal disease, malignancy, HIV, tuberculosis (TB) and obesity, to be associated with COVID­19 mortality. National demographic surveys have reported a high proportion of undiagnosed and untreated comorbid disease in South Africa (SA). OBJECTIVES: To determine the number of individuals with previously undiagnosed HIV, TB and non-communicable diseases (NCDs) among patients hospitalised with COVID­19, and the level of medical control of these chronic diseases. METHODS: We conducted a sentinel surveillance study to collect enhanced data on HIV, TB and NCDs among individuals with COVID­19 admitted to 16 secondary-level public hospitals in six of the nine provinces of SA. Trained surveillance officers approached all patients who met the surveillance case definition for inclusion in the study, and consenting patients were enrolled. The data collection instrument included questions on past medical history to determine the self-reported presence of comorbidities. The results of clinical and laboratory testing introduced as part of routine clinical care for hospitalised COVID­19 patients were collected for the study, to objectively determine the presence of hypertension, diabetes, HIV and TB and the levels of control of diabetes and HIV. RESULTS: On self-reported history, the most prevalent comorbidities were hypertension (n=1 658; 51.5%), diabetes (n=855; 26.6%) and HIV (n=603; 18.7%). The prevalence of self-reported active TB was 3.1%, and that of previous TB 5.5%. There were 1 254 patients admitted with COVID­19 (39.0%) who met the body mass index criteria for obesity. On clinical and laboratory testing, 87 patients were newly diagnosed with HIV, 29 with TB, 215 with diabetes and 40 with hypertension during their COVID­19 admission. There were 151/521 patients living with HIV (29.0%) with a viral load >1 000 copies/mL and 309/570 (54.2%) with a CD4 count <200 cells/µL. Among 901 patients classified as having diabetes, 777 (86.2%) had a glycated haemoglobin (HbA1c) level ≥6.5%. CONCLUSION: The study revealed a high prevalence of comorbid conditions among individuals with COVID­19 admitted to public hospitals in SA. In addition, a significant number of patients had previously undiagnosed hypertension, diabetes, HIV and active TB, and many and poorly controlled chronic disease, as evidenced by high HbA1c levels in patients with diabetes, and high viral loads and low CD4 levels in patients with HIV. The findings highlight the importance of strengthening health systems and care cascades for chronic disease management, which include prevention, screening for and effectively treating comorbidities, and ensuring secure and innovative supplies of medicines in primary healthcare during the COVID­19 pandemic.


Subject(s)
COVID-19 , Diabetes Mellitus , HIV Infections , Hypertension , Noncommunicable Diseases , Tuberculosis , COVID-19/epidemiology , Diabetes Mellitus/diagnosis , Diabetes Mellitus/epidemiology , Glycated Hemoglobin A , HIV Infections/diagnosis , HIV Infections/epidemiology , Hospitals, Public , Humans , Hypertension/epidemiology , Noncommunicable Diseases/epidemiology , Obesity/epidemiology , Pandemics , Prevalence , South Africa/epidemiology , Tuberculosis/diagnosis , Tuberculosis/epidemiology , Tuberculosis/prevention & control
9.
Rev Med Chil ; 150(4): 532-540, 2022 Apr.
Article in Spanish | MEDLINE | ID: covidwho-2055650

ABSTRACT

This article briefly discloses what home hospitalization consists of, its different models of care, and the benefits and difficulties associated with it. We also describe the operation of the home hospitalization unit of the Padre Hurtado Hospital in Santiago de Chile and the role it took in the context of the first wave of the COVID-19 Pandemic, specifically between March and August of the year 2020. We aim to share our experience with this emerging form of hospitalization that is already working in Chilean public hospitals. We also hope that this hospitalization modality will continue to grow over the years.


Subject(s)
COVID-19 , Pandemics , Chile/epidemiology , Hospitalization , Hospitals, Public , Humans
10.
BMJ Open ; 12(10): e064284, 2022 10 06.
Article in English | MEDLINE | ID: covidwho-2053221

ABSTRACT

OBJECTIVE: This study aimed to assess factors associated with poor medication adherence during the COVID-19 pandemic among hypertensive patients visiting public hospitals in Eastern Ethiopia. SETTING: Hospital-based cross-sectional study was conducted in Harari regional state and Dire Dawa Administration from 1 January to 30 February 2022. Both settings are found in Eastern Ethiopia. PARTICIPANTS: A total of 402 adult hypertensive patients who visited the chronic diseases clinic for follow-up were included in the study. MAIN OUTCOME MEASURES: The main outcome measure was poor medication adherence during the COVID-19 pandemic. RESULTS: The level of poor antihypetensive medication adherence was 63% (95% CI 48.1 to 67.9). Patients who had no formal education (adjusted OR (AOR)=1.56, 95% CI 1.03 to 4.30), existing comorbid conditions (AOR=1.98, 95% CI 1.35 to 4.35), self-funded for medication cost (AOR=2.05, 95% CI 1.34 to 4.73), poor knowledge about hypertension (HTN) and its treatment (AOR=2.67, 95% CI 1.45 to 3.99), poor patient-physician relationship (AOR=1.22, 95% CI 1.02 to 4.34) and unavailability of medication (AOR=5.05, 95% CI 2.78 to 12.04) showed significant association with poor medication adherence during the pandemic of COVID-19. CONCLUSION: The level of poor antihypertensive medication adherence was high in this study. No formal education, comorbidity, self-funded medication cost, poor knowledge about HTN and its treatment, poor patient-physician relationship, and unavailability of medication during the COVID-19 pandemic were factors significantly associated with poor adherence to antihypertensive medication. All stakeholders should take into account and create strategies to reduce the impact of the COVID-19 pandemic on medication adherence of chronic diseases.


Subject(s)
COVID-19 , Hypertension , Adult , Antihypertensive Agents/therapeutic use , COVID-19/epidemiology , Chronic Disease , Cross-Sectional Studies , Ethiopia/epidemiology , Health Knowledge, Attitudes, Practice , Hospitals, Public , Humans , Hypertension/drug therapy , Hypertension/epidemiology , Medication Adherence , Pandemics
11.
PLoS One ; 17(9): e0274169, 2022.
Article in English | MEDLINE | ID: covidwho-2029783

ABSTRACT

BACKGROUND: Wearing masks or personal protective equipment (PPE) has become an integral part of the occupational life of physicians due to the coronavirus disease 2019 (COVID-19) pandemic. Most physicians have been developing various health hazards related to the use of different protective gears. This study aimed to determine the burden and spectrum of various health hazards associated with using masks or PPE and their associated risk factors. METHODS: This cross-sectional survey was conducted in Dhaka Medical College from March 01-May 30, 2021, among physicians from different public hospitals in Dhaka, Bangladesh. We analyzed the responses of 506 physicians who completed case record forms through Google forms or hard copies. FINDINGS: The mean (SD) age of the respondents was 35.4 [7.7], and 69.4% were men. Approximately 40% were using full PPE, and 55% were using N-95 masks. A total of 489 (96.6%) patients experienced at least one health hazard. The reported severe health hazards were syncope, severe dyspnea, severe chest pain, and anaphylaxis. Headache, dizziness, mood irritation, chest pain, excessive sweating, panic attack, and permanent facial disfigurement were the minor health hazards reported. Extended periods of work in the COVID-19-unit, reuse of masks, diabetes, obesity, and mental stress were risk factors for dyspnea. The risk factors for headaches were female sex, diabetes, and previous primary headaches. Furthermore, female sex and reusing masks for an extended period (> 6 h) were risk factors for facial disfigurement. The risk factors for excessive sweating were female sex and additional evening office practice for an extended period. CONCLUSIONS: Healthcare workers experienced several occupational hazards after using masks and PPE. Therefore, an appropriate policy is required to reduce such risks.


Subject(s)
COVID-19 , Occupational Exposure , Physicians , Bangladesh/epidemiology , COVID-19/epidemiology , COVID-19/prevention & control , Chest Pain , Cross-Sectional Studies , Dyspnea , Female , Headache , Hospitals, Public , Humans , Male , Masks/adverse effects , Occupational Exposure/adverse effects , Personal Protective Equipment
12.
PLoS One ; 17(9): e0273923, 2022.
Article in English | MEDLINE | ID: covidwho-2021948

ABSTRACT

BACKGROUND: Influenza cause a clinical and economic burden for health systems and society. It is necessary to know the cost of the disease in order to perform cost-effectiveness assessments of preventive or treatment interventions. OBJECTIVE: Assess the costs of the care of children with influenza in a third level hospital in Mexico. METHODS: Longitudinal retrospective study based on the review of clinical files of children hospitalized with influenza. The use of resources used during their hospitalization in the emergency room, general ward, or PICU was logged, and the amount of supplies were multiplied by their corresponding prices to calculate the direct medical expenses. Descriptive statistics were used, and a GLM was adjusted in order to assess the effect of the clinical characteristics of the patients on the cost. Goodness of fit tests were performed. RESULTS: 132 files were reviewed, out of which 95% were of subjects who had comorbidities. Subjects admitted at the PICU generates the highest cost (mean $29,608.62 USD), when analyzing the total cost summarizing the three clinical areas (Emergency room, general ward and PICU) by age group, the highest cost was for patients over age 10 (mean $49,674.53 USD). Comorbidities increase the cost of hospitalization by $10,000.00 USD. CONCLUSIONS: Influenza causes a significant financial burden on the health system. Children with comorbidities increase the costs and children over 10 years uses a significant amount of resources and they are not a priority in immunization program. It is necessary to perform studies on the use of resources in the first and second attention levels, which represent the highest incidence of the disease.


Subject(s)
Influenza, Human , Pneumonia , Child , Cost of Illness , Hospitalization , Hospitals, Public , Humans , Influenza, Human/prevention & control , Mexico/epidemiology , Retrospective Studies
13.
Int J Environ Res Public Health ; 19(16)2022 08 09.
Article in English | MEDLINE | ID: covidwho-2023635

ABSTRACT

The healthcare sector is an ever-growing industry which produces a vast amount of waste each year, and it is crucial for healthcare systems to have an effective and sustainable medical waste management system in order to protect public health. Greek public hospitals in 2018 produced 9500 tons of hazardous healthcare wastes, and it is expected to reach 18,200 tons in 2025 and exceed 18,800 tons in 2030. In this paper, we investigated the factors that affect healthcare wastes. We obtained data from all Greek public hospitals and conducted a regression analysis, with the management cost of waste and the kilos of waste as the dependent variables, and a number of variables reflecting the characteristics of each hospital and its output as the independent variables. We applied and compared several models. Our study shows that healthcare wastes are affected by several individual-hospital characteristics, such as the number of beds, the type of the hospital, the services the hospital provides, the number of annual inpatients, the days of stay, the total number of surgeries, the existence of special units, and the total number of employees. Finally, our study presents two prediction models concerning the management costs and quantities of infectious waste for Greece's public hospitals and proposes specific actions to reduce healthcare wastes and the respective costs, as well as to implement and adopt certain tools, in terms of sustainability.


Subject(s)
Medical Waste Disposal , Waste Management , Delivery of Health Care , Greece , Hazardous Waste , Hospitals, Public , Humans , Public Sector
14.
Int J Health Care Qual Assur ; ahead-of-print(ahead-of-print)2022 Jan 24.
Article in English | MEDLINE | ID: covidwho-2018467

ABSTRACT

PURPOSE: The purpose of this research is to examine the impact of perceived service quality (PSQ) on the behavioural intention (BI) of patients in Indian government hospitals. The underlying mechanism of trust and patient satisfaction (SAT) is examined as multiple mediating effect. DESIGN/METHODOLOGY/APPROACH: Data from 510 respondents were collected using structured questionnaires. Six government hospitals, namely, S.M.S. Hospital, J.L.N. Hospital, New Medical College Hospital, Maharana Bhupal Medical Hospital, Mathuradas Hospital and P.B.N. Hospital, were selected from the cities of Jaipur, Ajmer, Kota, Udaipur, Jodhpur and Bikaner, respectively. The data were collected from adult patients (>18 years old) who spent at least two nights in a government hospital between 1 October, 2020 and 30 December, 2020. PSQ formed as a reflective-formative model was analysed using the repeated indicator approach. Structural equation modelling (SEM) using SMART-PLS software was used to test the hypothesised model(s) derived deductively from literature. FINDINGS: The findings support the following conclusions: (1) the positive relationship between PSQ and BI is significant; (2) SAT mediates the PSQ and BI relationship; (3) trust mediates the PSQ and BI relationship; (4) the mediation effect of SAT is stronger than that of trust. PRACTICAL IMPLICATIONS: The results indicate that, in order to enhance the positive BI of patients towards government hospitals, it is necessary for the hospitals to work on strategies to enhance the service quality provided to patients. The outcome of this study will enable state government hospitals to get a better understanding of the different dimensions of service quality and will help in observing the factors that contribute to patients' satisfaction and trust in building long-term relationships by encouraging a positive BI. ORIGINALITY/VALUE: There is a dearth of research in India that evaluates the relationships between the constructs PSQ, trust, BI and SAT in the context of healthcare service. This empirical study is an attempt to fill this gap by focussing on the government hospitals in India.


Subject(s)
Inpatients , Intention , Adolescent , Adult , Government , Hospitals, Public , Humans , Patient Satisfaction , Quality of Health Care , Surveys and Questionnaires
15.
Int J Environ Res Public Health ; 19(17)2022 Sep 05.
Article in English | MEDLINE | ID: covidwho-2010067

ABSTRACT

Sharp injuries, determining the risk of bloodborne infections and psychological distress in healthcare workers, may be prevented by a set of strategies, legally enforced in Europe through the Directive 2010/32/EU. To assess its level of implementation in Italy, a national survey was conducted in 2017 and again in 2021, evaluating the progress and possible drawbacks of the COVID-19 pandemic. Altogether, 285 safety managers and 330 nurses from a representative sample of 97 and 117 public hospitals were interviewed using a standardized questionnaire. Knowledge of the Directive requirements decreased significantly, with <60% of participants answering correctly in 2021, and nurses' attendance in specific courses dropped to 25% in 2021 compared to 54% in 2017. Over 75% of hospitals introduced multiple safety-engineered devices (SED), though total replacement occurred in <50% of cases; routine SED availability increased for blood collection (89%) and venous access devices (83%). Incorrect behaviors in handling sharps decreased significantly over time. Nurses' HBV vaccination coverage was high (89% in both surveys); in the last year, 97% were vaccinated against COVID, and 47% against influenza. Average annual injuries per hospital did not increase significantly (32 in 2021 vs. 26 in 2017). In 2017, nurses' perceived safety barriers were working in emergency situations (49%) and lack of resources (40%); in 2021, understaffing (73%), physical fatigue (62%), and handling difficulties while wearing full protective equipment (59%). Safety measures were implemented in Italian hospitals, and although the average injuries per hospital did not show a decrease, these measures could have helped protect healthcare workers during the pandemic, mitigating its potential impact on the increase in situations at risk of injury.


Subject(s)
COVID-19 , Needlestick Injuries , COVID-19/epidemiology , COVID-19/prevention & control , Health Personnel , Hospitals, Public , Humans , Italy/epidemiology , Needlestick Injuries/epidemiology , Pandemics/prevention & control
16.
Pan Afr Med J ; 42: 163, 2022.
Article in English | MEDLINE | ID: covidwho-2006519

ABSTRACT

Introduction: this study aimed to determine the prevalence of leaving against medical advice (LAMA) in the local context and the associated predictors to help develop effective strategies to reduce its likelihood. Methods: this study employed a retrospective approach using medical records of the 16233 patients between 2016 and 2020 at various government-subsidized hospitals in the Hail region of Saudi Arabia. Results: the prevalence of LAMA was the highest in 2019 (91.9%) and 2017 (21.45%) among insured and non-insured patients, respectively. Furthermore, it was the highest among patients aged 20-25 years and the lowest among patients aged 46 years and above. The incidence of LAMA was the highest (15.48% for males and 29.53% for females) in 2016. In 2016-2019, the most common reason for LAMA was "wanted medication only," while in 2020, the "fear of infection with COVID-19" was the main reason. High blood sugar was the most common diagnosis among the patients under consideration during the study period. Significant association was found between LAMA and patient's insurance status (t = 4.3123; p < 0.002); however, no association was found between LAMA and age (t = -0.8748; p > 0.658) and gender of patients (t = 1.9008; p > 0.302). Conclusion: strategies such as developing a suitable environment for patients and taking due care of their needs, providing individual consulting services, enhancing staff relations, and providing support to patients in need are vital. The likelihood of LAMA can be minimized by informing hospitalized patients and their relatives about the adverse effects of LAMA.


Subject(s)
Blood Glucose , COVID-19 , Female , Government , Hospitals, Public , Humans , Incidence , Male , Retrospective Studies
17.
Front Public Health ; 10: 919730, 2022.
Article in English | MEDLINE | ID: covidwho-1993881

ABSTRACT

Objective: It is essential to focus on the rehabilitation of COVID-19 patients after discharge to prevent their long-term sequelae, but there is less research on healthcare organizations enhancing rehabilitation services for patients discharged from COVID-19. Therefore, this study aimed to describe how a public hospital provides better rehabilitation services for patients after being identified as a designated rehabilitation hospital for patients with COVID-19 and attempted to combine the theory of organizational change to analyze how the hospital finally successfully transformed. Methods: A tertiary public hospital located in the center of Xi'an was selected for the study. It was identified as a designated hospital for the rehabilitation of patients discharged from the hospital with COVID-19. Nine hospital leaders and group leaders closely related to the rehabilitation management work were invited to participate in interviews to explore the fact about the hospital's rehabilitation work. The semi-structured interview with the hospital director and the focus group interview with group leaders were used for data collection. Two researchers independently conducted a thematic analysis of these responses. Results: One hundred and seventy-eight primary codes, 22 subcategories, six main categories, and one core theme were obtained from data analysis. The main categories include organization and coordination (overall deployment, transfer patient, and external coordination), hospital infection prevention and control (process transformation, ward disinfection, hospital infection training, inspection, and supervision), staff management (staff classification, closed-loop management, and staff health screening), individual services for patients (create an individual scheme, humanistic care, organize special activities, and strengthen communication and guidance), comprehensive supporting (basic medical guarantee, daily necessities guarantee, health and nutrition guarantee, and assistance fund guarantee) and positive transformation (strategic thinking, benchmarking, strengthen cohesion, and expand influence). Conclusion: The hospital had to transform its operations in the face of a complex environment during the pandemic. After deciding to transform, the hospital effectively prevented nosocomial infections and provided rehabilitation services to 583 patients through systematic management measures such as organizational coordination, staff classification, and personalized services. In the end, it has been successfully transformed and has grown rapidly. To ensure that it can continue to grow sustainably, the hospital enhanced the new ways that have emerged from this transformation.


Subject(s)
COVID-19 , Cross Infection , Hospitals, Public , Humans , Pandemics , Qualitative Research
18.
PLoS One ; 17(8): e0272818, 2022.
Article in English | MEDLINE | ID: covidwho-1993495

ABSTRACT

Seroprevalence of SARS-CoV-2 IgG among health care workers (HCWs) is crucial to inform infection control programs. Conflicting reports have emerged on the longevity of SARS-CoV-2 IgG. Our objective is to describe the prevalence of SARS-CoV-2 IgG in HCWs and perform 8 months longitudinal follow-up (FU) to assess the duration of detectable IgG. In addition, we aim to explore the risk factors associated with positive SARS-CoV-2 IgG. The study was conducted at a large COVID-19 public hospital in Riyadh, Saudi Arabia. All HCWs were recruited by social media platform. The SARS-CoV-2 IgG assay against SARS-CoV-2 nucleocapsid antigen was used. Multivariable logistic regression was used to examine association between IgG seropositive status and clinical and epidemiological factors. A total of 2528 (33% of the 7737 eligible HCWs) participated in the survey and 2523 underwent baseline serological testing in June 2020. The largest occupation groups sampled were nurses [n = 1351(18%)], physicians [n = 456 (6%)], administrators [n = 277 (3.6%)], allied HCWs [n = 205(3%)], pharmacists [n = 95(1.2%)], respiratory therapists [n = 40(0.5%)], infection control staff [n = 21(0.27%], and others [n = 83 (1%)]. The total cohort median age was 36 (31-43) years and 66.3% were females. 273 were IgG seropositive at baseline with a seroprevalence of 10.8% 95% CI (9.6%-12.1%). 165/185 and 44/112 were persistently IgG positive, at 2-3 months and 6 months FU respectively. The median (25th- 75th percentile) IgG level at the 3 different time points was 5.86 (3.57-7.04), 3.91 (2.46-5.38), 2.52 (1.80-3.99) respectively. Respiratory therapists OR 2.38, (P = 0.035), and those with hypertension OR = 1.86, (P = 0.009) were more likely to be seropositive. A high proportion of seropositive staff had prior symptoms 214/273(78%), prior anosmia was associated with the presence of antibodies, with an odds ratio of 9.25 (P<0.001), as well as fever and cough. Being a non-smoker, non-Saudi, and previously diagnosed with COVID-19 infection by PCR were statistically significantly different by seroprevalence status. We found that the seroprevalence of IgG against SARS-CoV-2 nucleocapsid antigen was 10.8% in HCWs at the peak of the pandemic in Saudi Arabia. We also observed a decreasing temporal trend of IgG seropositivity over 8 months follow up period.


Subject(s)
COVID-19 , Adult , Antibodies, Viral , COVID-19/epidemiology , Female , Health Personnel , Hospitals, Public , Humans , Immunoglobulin G , Male , Nucleocapsid , Prospective Studies , SARS-CoV-2 , Saudi Arabia/epidemiology , Seroepidemiologic Studies
19.
J Affect Disord ; 314: 193-200, 2022 10 01.
Article in English | MEDLINE | ID: covidwho-1959646

ABSTRACT

BACKGROUND: Mental health problems are common among clinicians working in public hospitals even in the late stage of the COVID-19 pandemic. Network analysis is a novel approach to explore interactions between mental health problems at the symptom level. This study examined the network structure of comorbid depression and anxiety and their associations with quality of life (QOL) among hospital clinicians in China during the late stage of the COVID-19 pandemic. METHODS: A total of 4931 participants were recruited from October 13 to 22, 2020. The nine-item Patient Health Questionnaire (PHQ-9), seven-item Generalized Anxiety Disorder Scale (GAD-7), and the World Health Organization Quality of Life Questionnaire-Brief Version (WHOQOL-BREF) were used to measure depressive and anxiety symptoms, and QOL, respectively. Central and bridge symptoms were identified with centrality and bridge centrality indices, respectively. Network stability was examined using the case-dropping procedure. RESULTS: The prevalence of depression (defined as PHQ-9 total score ≥ 5) was 35.1 % [95 % confidence interval (CI) = 33.73-36.41 %)], the prevalence of anxiety (GAD-7 total score ≥ 5) was 32.5 % (95 % CI = 31.20-33.84 %), while the prevalence of comorbid depression and anxiety was 26.9 % (95 % CI = 25.7-28.2 %). "Impaired motor skills", "Trouble relaxing" and "Uncontrollable worry" were the central symptoms in the whole depression-anxiety network. "Irritability", "Feeling afraid" and "Sad mood" were the most key bridge symptoms linking depression and anxiety. Three symptoms ("Fatigue", "Trouble relaxing" and "Nervousness") were the most strongly and negatively associated with QOL. Neither gender nor the experiences of caring for COVID-19 patients was associated with network global strength, distribution of edge weights or individual edge weights. LIMITATIONS: The causality between variables could not be established. Depressive and anxiety symptoms were assessed by self-report measures, which may result in recall bias and limitations in capturing clinical phenomena. CONCLUSIONS: Both the central (i.e., "Impaired motor skills", "Trouble relaxing" and "Uncontrollable worry") and bridge symptoms (i.e., "Irritability", "Feeling afraid" and "Sad mood") identified in this network analysis should be targeted in specific treatment and preventive measures for comorbid depressive and anxiety symptoms among clinicians in the late stage of the pandemic. Furthermore, "Fatigue", "Trouble relaxing" and "Nervousness" are key symptoms to address to improve clinicians' QOL.


Subject(s)
COVID-19 , Quality of Life , Anxiety/psychology , COVID-19/epidemiology , Depression/psychology , Hospitals, Public , Humans , Pandemics , Quality of Life/psychology
20.
Heart Lung ; 56: 112-117, 2022.
Article in English | MEDLINE | ID: covidwho-1907089

ABSTRACT

BACKGROUND: Coronavirus disease affects the world in multidisciplinary ways. In Ethiopia, it affects many people, including health professionals. Health institutions should have been ready to handle COVID-19 cases and protect their staff from this pandemic. Hospitals in eastern Amhara provide services for more than 30 million people. OBJECTIVES: To assess the readiness of government hospitals in eastern Amhara for coronavirus disease prevention and treatment in 2019. METHODS: The institutional-based descriptive cross-sectional study design was conducted in 28 governmental hospitals in the eastern Amhara region. A structured checklist exported to the word processing system online link was created. Randomly selected nurses in each hospital were virtually trained and collected the data; the link was shared with them. We use SPSS version 23 for data cleaning and analysis. For data summary and presentation, frequency, mean, tables, graphs, and text were used. Using concept analysis, different sections of these hospitals were assessed. A linear regression was done and Pearson correlation coefficient (r) values were used to measure the degree of relationship between dependent and independent variables. RESULTS: This study indicates that more than half (57.14%) responded "no" to the questions, suggesting unpreparedness. The age of the hospital (r = 0.25), distance from the regional capital city (r = 0.113), distance from the capital city (r = 0.125), and location of the hospital (r = 0.094) had little relationship with the readiness of the hospital for COVID-19 disease prevention and care. CONCLUSION AND RECOMMENDATION: In this most hospitals were not ready to handle COVID-19 cases and couldn't protect staff from this pandemic. Therefore, local and regional health offices and the federal ministry of health, as well as other health organizations, should enhance their capacity to fight COVID 19.


Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , COVID-19/prevention & control , Cross-Sectional Studies , Ethiopia/epidemiology , Hospitals, Public , Health Personnel
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