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1.
J Med Life ; 15(9): 1119-1128, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-2146200

ABSTRACT

The SARS-CoV-2 pandemic has changed lives around the world. In particular, healthcare workers faced significant challenges as a result of the pandemic. This study investigates the seroprevalence of SARS-CoV-2 in March-April 2020 in Germany among healthcare workers and relates it to questionnaire data. In June 2020, all employees of the reporting hospital were offered a free SARS-CoV-2 antibody test. The first 2,550 test results were sent along with study documents. The response rate was 15.1%. The COVID-19 PCR test prevalence amongst health care workers in this study was 1.04% (95% CI 0.41-2.65%), higher by a factor of 5 than in the general population (p=0.01). The ratio of seroprevalence to PCR prevalence was 1.5. COVID-19-associated symptoms were also prevalent in the non-COVID-19-positive population. Only two symptoms showed statistically significant odds ratios, loss of smell and loss of taste. Health care workers largely supported non-pharmaceutical interventions during the initial lockdown (93%). Individual behavior correlated significantly with attitudes toward policy interventions and perceived individual risk factors. Our data suggest that healthcare workers may be at higher risk of infection. Therefore, a discussion about prioritizing vaccination makes sense. They also support offering increased SARS-CoV-2 testing to hospital workers. It is concluded that easier access to SARS-CoV-2 testing reduces the number of unreported cases. Furthermore, individual attitudes toward rules and regulations on COVID-19 critically influence compliance. Thus, one goal of public policy should be to maintain high levels of support for non-pharmaceutical interventions to keep actual compliance high.


Subject(s)
COVID-19 , Pandemics , Humans , COVID-19/epidemiology , Seroepidemiologic Studies , Prevalence , COVID-19 Testing , SARS-CoV-2 , Communicable Disease Control , Hospitals, University , Personnel, Hospital , Surveys and Questionnaires
2.
PLoS One ; 17(11): e0272919, 2022.
Article in English | MEDLINE | ID: covidwho-2140469

ABSTRACT

INTRODUCTION: Hospital-acquired infections of communicable viral diseases (CVDs) have been posing a tremendous challenge to healthcare workers globally. Healthcare personnel (HCP) is facing a consistent risk of viral infections, and subsequently higher rates of morbidity and mortality. MATERIALS AND METHODS: We proposed a domain-knowledge-driven infection risk model to quantify the individual HCP and the population-level risks. For individual-level risk estimation, a time-variant infection risk model is proposed to capture the transmission dynamics of CVDs. At the population-level, the infection risk is estimated using a Bayesian network model constructed from three feature sets, including individual-level factors, engineering control factors, and administrative control factors. For model validation, we investigated the case study of the Coronavirus disease, in which the individual-level and population-level infection risk models were applied. The data were collected from various sources such as COVID-19 transmission databases, health surveys/questionaries from medical centers, U.S. Department of Labor databases, and cross-sectional studies. RESULTS: Regarding the individual-level risk model, the variance-based sensitivity analysis indicated that the uncertainty in the estimated risk was attributed to two variables: the number of close contacts and the viral transmission probability. Next, the disease transmission probability was computed using a multivariate logistic regression applied for a cross-sectional HCP data in the UK, with the 10-fold cross-validation accuracy of 78.23%. Combined with the previous result, we further validated the individual infection risk model by considering six occupations in the U.S. Department of Labor O*Net database. The occupation-specific risk evaluation suggested that the registered nurses, medical assistants, and respiratory therapists were the highest-risk occupations. For the population-level risk model validation, the infection risk in Texas and California was estimated, in which the infection risk in Texas was lower than that in California. This can be explained by California's higher patient load for each HCP per day and lower personal protective equipment (PPE) sufficiency level. CONCLUSION: The accurate estimation of infection risk at both individual level and population levels using our domain-knowledge-driven infection risk model will significantly enhance the PPE allocation, safety plans for HCP, and hospital staffing strategies.


Subject(s)
COVID-19 , Cross Infection , Virus Diseases , Humans , COVID-19/epidemiology , Retrospective Studies , Cross-Sectional Studies , Bayes Theorem , Cross Infection/prevention & control , Personnel, Hospital , Hospitals , Delivery of Health Care
3.
Int J Environ Res Public Health ; 19(22)2022 Nov 18.
Article in English | MEDLINE | ID: covidwho-2116129

ABSTRACT

OBJECTIVES: To assess trends in overall health (mental and physical) and psychosocial factors in a population of workers (both healthcare and non-healthcare) in a French teaching hospital during the first year of the SARS-CoV-2 pandemic in France. METHODS: A validated version of the SATIN questionnaire with adapted scoring was used to collect data on health and impacts of work stressors. This questionnaire was sent to all workers at the hospital in T1 (July-August 2020) and T2 (July-August 2021) and self-administered online. RESULTS: A total of 1313 participants who completed the questionnaire at T1 and 826 at T2 were included. Overall, 568 workers completed the questionnaire at T1 and T2. We found a deterioration in overall health and especially stress and mental health in hospital workers and healthcare workers (HCWs), with a negative impact of the workload and work environment. CONCLUSIONS: The SARS-CoV-2 pandemic impacted negatively the mental health, work stressors, and psychosocial perceptions of both HCW and non-HCW in a French hospital. The study confirms that hospital workers are an important target.


Subject(s)
COVID-19 , SARS-CoV-2 , Humans , Pandemics , Global Health , Longitudinal Studies , COVID-19/epidemiology , Personnel, Hospital , Hospitals, Teaching
4.
J Health Organ Manag ; ahead-of-print(ahead-of-print)2022 Sep 19.
Article in English | MEDLINE | ID: covidwho-2097569

ABSTRACT

PURPOSE: This paper explores the role of hospital cleaners and their contribution to healthcare safety. Few studies have examined the activities and input of hospital cleaners, rendering them largely invisible in healthcare research. Yet, as coronavirus disease 2019 (COVID-19) has demonstrated, this sizeable workforce carries out tasks critical to healthcare facilities and wider health system functioning. DESIGN/METHODOLOGY/APPROACH: Drawing on the work of Habermas, the authors examine the literature surrounding cleaners and quality and safety in healthcare. The authors theorise cleaners' work as both instrumental and communicative and examine the perceptions of healthcare professionals and managers, as well as cleaners themselves, of healthcare professionals and managers' role and contribution to quality and safety. FINDINGS: Cleaners are generally perceived by the literature as performing repetitive - albeit important - tasks in isolation from patients. Cleaners are not considered part of the "healthcare team" and are excluded from decision-making and interprofessional communication. Yet, cleaners can contribute to patient care; ubiquity and proximity of cleaners to patients offer insights and untapped potential for involvement in hospital safety. ORIGINALITY/VALUE: This paper brings an overdue focus to this labour force by examining the nature and potential of their work. This paper offers a new application of Habermas' work to this domain, rendering visible how the framing of cleaners' role works to exclude this important workforce from participation in the patient safety agenda.


Subject(s)
COVID-19 , COVID-19/epidemiology , Hospitals , Humans , Patient Safety , Personnel, Hospital , Workforce
6.
J Clin Psychiatry ; 82(3)2021 04 27.
Article in English | MEDLINE | ID: covidwho-2066786

ABSTRACT

OBJECTIVE: The coronavirus disease 2019 (COVID-19) pandemic has led to an increased risk of psychiatric symptoms among frontline health care workers (FHCWs). In the current study, a novel "symptomics" approach was employed to examine the association between acute transdiagnostic symptoms of posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and generalized anxiety disorder (GAD) and burnout and work and relationship difficulties in FHCWs at an urban tertiary care hospital in New York City. METHODS: Symptoms of COVID-19-related PTSD (4-item PTSD Checklist-5), MDD (Patient Health Questionnaire-8), GAD (Generalized Anxiety Disorder-7), burnout (Single-Item Mini-Z Burnout Assessment), and functional difficulties (Brief Inventory of Psychosocial Functioning) were assessed. Relative importance analyses were conducted to identify PTSD, MDD, and GAD symptoms associated with burnout and functional difficulties. RESULTS: The total number of eligible participants included 6,026 presumed FHCWs, of which 3,360 (55.8%) completed the survey and 2,579 (76.8%) of whom endorsed directly treating patients with COVID-19 and provided sufficient responses to our outcome variables for analysis. Feeling tired/having little energy, being easily annoyed or irritable, and feeling nervous, anxious, or on edge were most strongly associated with burnout; feeling tired/having little energy accounted for the greatest amount of explained variance (> 15%). Negative expectations of oneself or the world, trouble concentrating, and feeling easily annoyed or irritable were most strongly associated with work difficulties; negative expectations of oneself or the world accounted for the greatest amount of explained variance (> 9%). Feeling easily annoyed or irritable, negative expectations about oneself or the world, and feeling bad about oneself were most strongly associated with relationship difficulties; feeling easily annoyed or irritable accounted for the greatest amount of explained variance (> 10%). CONCLUSIONS: Results of this study underscore the importance of a transdiagnostic, symptom-based approach when examining associations between acute psychopathology and burnout and functional difficulties in FHCWs. Further work is needed to determine if early interventions aimed at ameliorating specific psychiatric symptoms may help mitigate risk for peri- and posttraumatic burnout and functional difficulties in this population.


Subject(s)
Anxiety Disorders/physiopathology , Burnout, Professional/physiopathology , COVID-19/therapy , Depressive Disorder, Major/physiopathology , Fatigue/physiopathology , Irritable Mood/physiology , Personnel, Hospital , Stress Disorders, Post-Traumatic/physiopathology , Adult , Female , Hospitals, Urban , Humans , Male , Middle Aged , New York City , Tertiary Care Centers
7.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz ; 65(11): 1178-1187, 2022 Nov.
Article in German | MEDLINE | ID: covidwho-2059773

ABSTRACT

BACKGROUND: A critical factor in achieving widespread immunity against COVID-19 is the willingness of previously unvaccinated individuals to get vaccinated. Medical staff play a key role in this, as they ensure healthcare during the pandemic and for many serve as a source of information about vaccinations. Among the factors that negatively influence the general willingness to get vaccinated are conspiracy assumptions and the spread of misinformation. OBJECTIVE: The willingness of hospital staff in Germany to get vaccinated and various influencing variables were examined to obtain indicators that could help increase the general willingness to get vaccinated. METHODS: Between January and June 2021, a voluntary and anonymous online survey conducted as part of the egePan joint project of the national network for university medicine (funded by the Federal Ministry of Education and Research) was used to assess the willingness to be vaccinated, individual social characteristics, the belief in conspiracy assumptions, and communication items in German hospitals. RESULTS: In comparison with the general population, physicians and scientific staff in particular indicated an increased willingness to get vaccinated. Conspiracy assumptions were not very widespread but most frequent among administrative and nursing staff. Conspiracy assumptions were negatively associated with the willingness to get vaccinated. Predictors for a higher willingness to get vaccinated were the perceived safety and effectiveness of vaccinations and a higher age. DISCUSSION: Since the perceived safety and effectiveness of vaccinations have a positive effect on the willingness to get vaccinated, educational work and transparent information transfer could counteract the spread of conspiracy assumptions and increase vaccination rates among hospital staff.


Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , COVID-19/prevention & control , Germany/epidemiology , Pandemics/prevention & control , Personnel, Hospital , Communication , Vaccination
8.
Medwave ; 22(9): e2536, 2022 Oct 04.
Article in English, Spanish | MEDLINE | ID: covidwho-2056186

ABSTRACT

Introduction: SARS-CoV-2 infection in healthcare professionals represents a threat to the healthcare system. Objectives: To identify factors associated with complications from COVID-19 in healthcare workers infected by SARS-CoV-2, in a specialized national hospital level III in Peru in 2020. Methods: This is a retrospective cohort study. Health personnel who were working at Instituto Nacional Materno Perinatal of Peru participated. The clinical and epidemiological characteristics and results of the Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) test were collected from the medical records and epidemiological files. Simple and multiple regression models were used to estimate the risk factors of complications due to COVID-19. Results: We found 1048 suspected cases, and 26.2% had a confirmed SARS-CoV-2 infection. Of those infected, 20.8% had comorbidity, and 55% reported contact with COVID-19 patients in health care settings. Moreover, 27.4% of infected workers were administrative personnel, 24.1% were nursing technicians, 18.3% were nurses, and 13.1% were physicians. We also found that 24.1% presented complications from COVID-19, and three workers died. In a multiple regression, the risk factors for complications due to COVID-19 were the presence of comorbidity (risk ratio: 2.94; 95% confidence interval: 1.95 to 4.42), 30 years or older (1.28; 0.6 to 2.75), 60 years or older (2.04; 0.88 to 4.74), male sex (1.1; 0.71 to 1.7) and care work area (1.02; 0.06 to 2.62). Conclusions: The findings in the present study show an association between the presence of comorbidities and an increased risk of presenting complications due to COVID-19 in healthcare workers, regardless of age, sex and area of work.


Introducción: La infección por SARS-CoV-2 en profesionales sanitarios representa una amenaza para el sistema de salud. Objetivos: Identificar factores asociados a complicaciones por COVID-19 en trabajadores sanitarios, infectados por SARS-CoV-2 y que pertenecen a un hospital nacional especializado de tercer nivel de Perú en el año 2020. Métodos: Estudio de cohorte retrospectivo. Participaron trabajadores sanitarios infectados por SARS-CoV-2, que trabajaron en el Instituto Nacional Materno Perinatal entre abril y diciembre de 2020. Se recogieron características clínicas y epidemiológicas, más resultados de la prueba de reacción en cadena de la polimerasa con transcriptasa inversa (PCR-TR) a partir de historias clínicas y fichas clínico epidemiológicas. Se utilizó regresión simple y múltiple para estimar los riesgos relativos de complicaciones por COVID-19. Resultados: Se identificaron 1048 casos sospechosos, de ellos 26,2% tuvo infección confirmada de SARS-CoV-2. Del personal sanitario infectado, el 20,8% tuvo alguna comorbilidad, 55% manifestó atención a pacientes COVID-19, 27,4% fue personal administrativo, 24,1% técnico en enfermería, 18,3% licenciada de enfermería y 13,1% personal médico. El 24,1% presentó complicaciones por COVID-19 y tres trabajadores sanitarios fallecieron. En regresión múltiple, se obtuvo riesgos relativos para complicaciones por COVID-19 según presencia de comorbilidad (riesgo relativo: 2,94; intervalo de confianza 95%: 1,95 a 4,42), edad de 30 años a más ( 1,28; 95%: 0,6 a 2,75), 60 años a más ( 2,04; 95%: 0,88 a 4,74), sexo masculino ( 1,1; 95%: 0,71 a 1,7) y área laboral asistencial ( 1,02; 95%: 0,06 a 2,62). Conclusiones: Los hallazgos sugieren que en trabajadores sanitarios infectados por SARS-CoV-2, la presencia de comorbilidades está asociada a complicaciones por COVID-19, independientemente de la edad, el sexo y del área laboral.


Subject(s)
COVID-19 , COVID-19/complications , Health Personnel , Hospitals , Humans , Male , Personnel, Hospital , Retrospective Studies , SARS-CoV-2
9.
J Rural Health ; 38(4): 795-804, 2022 09.
Article in English | MEDLINE | ID: covidwho-2038120

ABSTRACT

PURPOSE: Working in a hospital setting during a global health pandemic can lead to increased levels of anxiety, stress, burnout, and depression. Anecdotal evidence exists, but there is little research utilizing clinically validated tools to measure hospital staff psychological distress. METHODS: In Summer 2021, 771 hospital staff in North Dakota responded to an electronic survey collecting demographic data and employing validated behavioral health screening tools to assess anxiety, depression, emotional distress, and work-related quality of life. FINDINGS: Compassion satisfaction was significantly higher for those who worked in rural areas than urban [t(769) = -1.99, P = .0467]. The burnout rating was significantly higher for those who worked in urban areas than rural [t(769) = 2.23, P = .0261)]. There was no significant geographic variation in stress, anxiety, or depression. Anxiety, depression, burnout, and stress were all significantly higher for those who worked directly with COVID-19 patients than those who did not, regardless of hospital location. CONCLUSIONS: Hospital staff caring for COVID-19 patients experienced equitable (and high) levels of depression and anxiety. However, data indicate that rural providers experienced greater protective factors, resulting in lower rates of burnout and higher compassion satisfaction. Rural communities, hospitals, and health systems may have characteristics that could be duplicated in urban areas to support hospital staff well-being. Support and promotion of mental wellness must also come from the hospital system, and health care and policy leaders. If we do not care for our hospital staff, there will not be hospital staff left to care for the community.


Subject(s)
Burnout, Professional , COVID-19 , Anxiety/epidemiology , Burnout, Professional/epidemiology , Burnout, Professional/psychology , COVID-19/epidemiology , Depression/epidemiology , Depression/psychology , Global Health , Hospitals , Humans , Pandemics , Personnel, Hospital , Quality of Life , Surveys and Questionnaires , Workforce
10.
Intern Med J ; 52(10): 1821-1825, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-2001649

ABSTRACT

A survey administered to staff at five hospitals investigated changes in unprofessional behaviour, teamwork and co-operation during the COVID-19 pandemic. From 1583 responses, 76.1% (95% confidence interval (CI): 74.0-78.2%) reported no change or a decrease in unprofessional behaviours. Across all professional groups, 43.6% (n = 579, 95% CI: 41.0-46.3%) reported improvements in teamwork and co-operation. Findings suggest that intensifying work demands, such as those resulting from the pandemic, are not a major trigger for unprofessional behaviour, and root causes lie elsewhere.


Subject(s)
COVID-19 , Humans , Pandemics , Professional Misconduct , Personnel, Hospital , Hospitals
11.
PLoS One ; 17(8): e0272856, 2022.
Article in English | MEDLINE | ID: covidwho-1993497

ABSTRACT

BACKGROUND: While healthcare workers (HCWs) are at risk of occupational exposure to SARS-CoV-2 infection, the virus transmission involving them might be exceeding in the non-occupational settings. This study examined the extent of adherence to infection prevention practices (IPPs) against COVID-19 in their daily life and its associated factors among staff members in a national medical center designated for COVID-19 treatment in Tokyo, Japan. METHODS: This cross-sectional study was conducted in July 2020 among 1,228 staff of National Center for Global Health and Medicine (NCGM). We asked participants about their adherence on six IPPs recommended by the WHO in their daily lives, which included wearing masks, maintaining hand and respiratory hygiene, avoiding 3Cs and social distancing. We defined 100% adherence (6 points) to IPPs as good adherence and run logistic regression model to estimate odds ratios (ORs) and 95% confidence intervals (CIs) of IPPs. RESULTS: Nearly 100% of NCGM staff members adhered to four out of six IPPs assessed in this study: washing or sanitizing hands (99.6%), good cough etiquette (99.6%), wearing mask (98.9%), and avoiding 3Cs (98.3%). Doctors (AOR = 2.18, CI: 1.36-3.49) and female staff members (AOR = 1.95, CI: 1.36-3.49) were more likely to adhere to IPPs compared with non-clinical staffs and male counterparts. Good adherence to IPPs tended to increase with older age, with highest adherence among those who were 50 years or above (AOR = 2.53, CI: 1.49-4.29). CONCLUSION: This study revealed that the IPPs among NCGM staff was remarkably good. Older and female staff members, and doctors showed a higher adhere to IPPs compared with their counterparts. Additional effort to improve adherence to IPPs among the younger and male staff members could contribute to reduce infection risk in their daily life, which can eventually prevent nosocomial infection.


Subject(s)
COVID-19 , COVID-19/drug therapy , COVID-19/epidemiology , COVID-19/prevention & control , Cross-Sectional Studies , Female , Health Personnel , Hospitals , Humans , Japan/epidemiology , Male , Personnel, Hospital , SARS-CoV-2 , Tokyo/epidemiology
12.
Mikrobiyol Bul ; 56(3): 387-403, 2022 Jul.
Article in Turkish | MEDLINE | ID: covidwho-1988330

ABSTRACT

The Coronavirus disease 2019 (COVID-19) pandemic still continues around the world by making peaks with different variants. In the fight against COVID-19, vaccination is currently the only protective measure. In Turkey, vaccination started firstly in healthcare workers on 13 January 2021 with the CoronaVac (Sinovac Biotech, Chinese) vaccine, and booster doses were administered with the CoronaVac and Comirnaty vaccines in July 2021. In this cross-sectional study, it was aimed to determine the humoral and cellular immunity levels of the employees of the TOBB ETU Hospital 2.5-3.5 months after three doses of vaccination and identify the effective factors. With the power analysis that was conducted with the G*Power software, it was determined to be suitable to include 40 TOBB ETU Hospital workers who had their third dose with the CoronaVac vaccine and 60 workers of the same hospital who had their third dose with the Comirnaty (Pfizer Biontech, Germany) vaccine, and age- and sex-matching was considered by selecting 60 workers randomly from among 223 workers who had Comirnaty as their third dose. The study excluded individuals who had a previous COVID-19 infection or had a positive PCR test result. After collecting blood samples on 18-22 October 2021, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) immunoglobulin G levels were studied with the chemiluminescence immunoassay method using a Beckman-Access device (Beckman Coulter Inc., CA, USA) for humoral immunity, and T-SPOT test (T-SPOT. COVID SARS-CoV-2 test-Oxford Immunotec, Singapur) was carried out for cellular immunity. Additionally, demographic data, habits, personal information such as weight and height, reasons for choosing the vaccine and post-vaccine side effects were obtained through the data collection form. Data collection was completed on 29 November 2021. As a result, among the healthcare workers who had received their third dose of vaccine with Comirnaty and CoronaVac; while 25% of those who received three doses of CoronaVac had humoral immunity, 93.3% humoral immunity was determined in the heterogeneous vaccine group with two doses of CoronaVac and one dose of Comirnaty vaccine (p<0.05). Cellular immunity was found to be higher (88.3%, 70%) in those who received the heterologous vaccine than those who completed three doses of the same vaccine (p<0.05). In the heterogeneous vaccination group consisting of the healthcare workers who had their third vaccine dose with Comirnaty and those who had it with CoronaVac, humoral and cellular immunity levels were found high. Among the participants whose humoral immunity was found negative, cellular immunity was present in 75% of those who had Comirnaty as their third dose and 63.3% of those who had CoronaVac. While no significant relationship was found between immunity levels and age, sex or body mass index (BMI), the levels of both forms of immunity were lower in those who had chronic diseases. Among the participants, physicians preferred the third dose of Comirnaty vaccine at a rate of 71.4% and laboratory workers preferred this vaccine at a rate of 80% according to the workplace. In the third dose vaccine preference reasons, it was stated that 55% would continue with the same vaccine, experience fewer side effects, 44% provide more immunity and 9% do not prevent going abroad. The incidence of side effects after the third dose of vaccine was 53% higher in those who received the Comirnaty vaccine than in those who received CoronaVac (35%). Based on these data, it was concluded that heterologous vaccination should be preferred in vaccination strategies, and knowing cellular immunity levels is important for the decision. There is a need for more comprehensive and follow-up studies on how long humoral and especially cellular immunity lasts.


Subject(s)
COVID-19 Vaccines , COVID-19 , Personnel, Hospital , Adult , Antibodies, Viral , COVID-19/immunology , COVID-19/prevention & control , COVID-19 Vaccines/administration & dosage , Cross-Sectional Studies , Female , Humans , Immunity, Cellular , Male , SARS-CoV-2 , Vaccination
13.
Soc Sci Med ; 310: 115243, 2022 10.
Article in English | MEDLINE | ID: covidwho-1984060

ABSTRACT

BACKGROUND: Transplant rates in Ontario rose steeply in the decade prior to the COVID-19 pandemic. Reasons for that increase remain unclear, but the inter-organizational arrangement of organ donation programs may have contributed. However, there is a paucity of literature investigating these inter-organizational arrangements, with a limited understanding of how communication facilitates organ donation. Understanding these arrangements may help to re-establish rising organ donation rates post-pandemic. OBJECTIVE: To describe interprofessional interactions of Organ and Tissue Donation Coordinators (OTDCs) during organ donation cases, within organ donation programs in Ontario, from an organizational perspective (describing structure, context, process). METHODS: Mixed-method social network analysis (SNA) approach analyzing 14 organ donation cases just before the COVID-19 pandemic. RESULTS: Structure: Social network graphs depict the joint work performed by hospital staff and OTDCs, with a great part of the communication being processed through the OTDC. CONTEXT: Network density ranged from 0.05 to 0.24 across cases, and health care professionals perceived an atmosphere of shared vision and trust among team members. PROCESS: Most networks had a degree centralization <0.50 suggesting a decentralized information flow, and participants perceived decisions being jointly made. The characteristic path length of cases ranged from 1.6 to 3.2, suggesting potential for rapid information diffusion. Overall, data reinforced the OTDC role of intermediator within the communication process, and hospital staff perceived OTDCs as central players. Hospital staff and OTDCs reported frustration with some aspects of the flow of information during the organ allocation processes. CONCLUSION: Findings from this study provide a network map of communications within organ donation cases and reinforce the importance of the OTDC role. Opportunities for quality improvement within these processes are identified.


Subject(s)
COVID-19 , Tissue and Organ Procurement , COVID-19/epidemiology , Humans , Ontario , Pandemics , Personnel, Hospital , Social Network Analysis
14.
JAMA Netw Open ; 5(8): e2224657, 2022 08 01.
Article in English | MEDLINE | ID: covidwho-1971179

ABSTRACT

Importance: Despite the high 3-dose vaccination rate among health care workers (HCWs) in Israel, a high rate of SARS-CoV-2 breakthrough infections in this group was observed during the Omicron wave. As a result, the Israeli Ministry of Health decided to recommend a fourth vaccine dose to medical staff. Objective: To evaluate the benefit of a fourth BNT162b2 vaccine dose on the breakthrough infection rate among HCWs. Design, Setting, and Participants: This multicenter cohort study was performed in January 2022, the first month of the 4-dose vaccination campaign, during a surge of the Omicron variant wave. All health care workers at 11 general hospitals in Israel who had been vaccinated with 3 doses up to September 30, 2021, and had not contracted COVID-19 before the vaccination campaign were included. Exposures: Vaccination with a fourth dose of the BNT162b2 vaccine during January 2022. Main Outcomes and Measures: Breakthrough COVID-19 infections in 4-dose recipients vs 3-dose recipients measured by a polymerase chain reaction test result positive for SARS-CoV-2. Health care workers were tested based on symptoms or exposure. Results: A total of 29 611 Israeli HCWs (19 381 [65%] female; mean [SD] age, 44 [12] years) had received 3 vaccine doses between August and September 2021; of these, 5331 (18%) received the fourth dose in January 2022 and were not infected by the first week after vaccination. Overall breakthrough infection rates were 368 of 5331 (7%) in the 4-dose group and 4802 of 24280 (20%) in the 3-dose group (relative risk, 0.35; 95% CI, 0.32-0.39). Similar reductions were found in a matched analysis by the exact day of receiving the third vaccine (relative risk, 0.61; 95% CI, 0.54-0.71) and in a time-dependent Cox proportional hazards regression model (adjusted hazard ratio, 0.56; 95% CI, 0.50-0.63). In both groups, no severe disease or death occurred. Conclusions and Relevance: In this cohort study, the fourth BNT162b2 vaccine dose resulted in a reduced breakthrough infection rate among hospital staff. This reduction was lower than that observed after the third dose; nevertheless, considering the high infectivity of the Omicron variant, which led to critical medical staff shortages, a fourth vaccine dose should be considered to mitigate the infection rate among HCWs.


Subject(s)
COVID-19 , Influenza Vaccines , Influenza, Human , Attitude of Health Personnel , BNT162 Vaccine , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines , Child , Cohort Studies , Female , Humans , Influenza, Human/prevention & control , Israel/epidemiology , Male , Personnel, Hospital , SARS-CoV-2 , Surveys and Questionnaires
15.
Int J Occup Med Environ Health ; 35(5): 571-584, 2022 Oct 03.
Article in English | MEDLINE | ID: covidwho-1955042

ABSTRACT

OBJECTIVES: The pandemic caused by the novel coronavirus (SARS-CoV-2) affected a disproportionately high percentage of healthcare workers (HCWs). The aim of the study was to assess the seroprevalence of SARS-CoV-2-specific IgG antibodies in nurses and clinicians working in 2 Slovenian regional hospitals, and to identify the factors associated with seropositivity. MATERIAL AND METHODS: The study was designed as a crosssectional study. Clinicians and nurses were invited to participate in November-December 2020. The respondents (813, 65.8%) completed a questionnaire and consented to provide 10 ml of blood for determining the presence of SARS-CoV-2 IgG antibodies. RESULTS: The authors observed a seroprevalence rate of 20.4%. The results of the univariate analysis proved that the age of a nurse or clinician was the factor most strongly associated with seropositivity - in fact, the youngest nurses and clinicians were 8.33 times more likely to be seropositive than those in the oldest age group (p = 0.041). Being in contact with a family/household member who was SARS-CoV-2-positive was also a very important factor. In the work-related factors group, being in the contact with a SARS-CoV-2-positive colleague (OR = 2.35, p = 0.026) or being in contact with a COVID-19 patient (OR = 1.96, p = 0.004) correlated with seropositivity. In the primary work location/department group, the only significant association appeared among those working in surgical, ENT or ophthalmology departments. The results of the multivariate analysis further supported the thesis that the age of nurses and clinicians was the factor most strongly associated with seropositivity. The youngest nurses and clinicians were 12.5 times more likely to be seropositive than those in the oldest age group (p = 0.024). Being in contact with a SARS-CoV-2-positive family/household member remained the second most important factor. CONCLUSIONS: A significant number of clinicians and nurses working in secondary healthcare were infected in the first 9 months of the pandemic. Int J Occup Med Environ Health. 2022;35(5):571-84.


Subject(s)
COVID-19 , SARS-CoV-2 , Antibodies, Viral , COVID-19/epidemiology , Health Personnel , Humans , Immunoglobulin G , Pandemics , Personnel, Hospital , Seroepidemiologic Studies , Slovenia/epidemiology
16.
HERD ; 15(4): 343-353, 2022 10.
Article in English | MEDLINE | ID: covidwho-1928044

ABSTRACT

The COVID-19 pandemic has created considerable implications for healthcare staff around the globe. During the pandemic, the frontline healthcare workers experience intense anxiety, stress, burnout, and psychological breakdown, with severe implications on their mental and physical well-being. In addition to these implications, anxiety and stress can hinder their productivity and ability to perform their duties efficiently. The literature indicates that hospital gardens and contact with nature can help alleviate psychological distress among hospital staff. However, few studies investigated the role of outdoor spaces as areas for respite and work breaks in healthcare facilities during the pandemic. The present opinion paper highlights the challenges of job stress and psychological distress health workers face during the pandemic. This article also underscores the role of hospital outdoor spaces and garden facilities in coping with the challenges. While other measures to reduce stress among hospital staff and ensure their health and safety are important, hospital administrators and relevant government agencies should also emphasize the provision of gardens and open spaces in healthcare facilities. These spaces can act as potential areas for respite for hospital staff to help them cope with the stress and anxiety accumulated through working under crises.


Subject(s)
COVID-19 , COVID-19/epidemiology , Delivery of Health Care , Health Personnel/psychology , Hospitals , Humans , Pandemics , Personnel, Hospital
17.
JAMA Netw Open ; 5(7): e2220677, 2022 07 01.
Article in English | MEDLINE | ID: covidwho-1919182

ABSTRACT

Importance: Health care workers face serious mental health challenges as a result of ongoing work stress. The COVID-19 pandemic exacerbated that stress, resulting in high rates of anxiety, depression, and burnout. To date, few evidence-based programs targeting mental health outcomes in health care workers have been described. Objective: To assess the feasibility, acceptability, and preliminary outcomes of a skills-based coaching program designed to reduce stress and build resilience. Design, Setting, and Participants: A pilot cohort study was conducted between September 2020 and April 2021 using preprogram and postprogram assessments and a mixed-methods analysis. Duration of follow-up was 7 weeks. The coaching program was delivered via video conferencing. Participants were health care workers and staff from a large urban health system. Intervention: The Promoting Resilience in Stress Management (PRISM) program, a manualized, skills-based coaching program originally developed for adolescents and young adults with serious/chronic illness, was adapted to support health care workers and staff ("PRISM at Work"). It included 6 weekly 1-hour group sessions. Main Outcomes and Measures: Feasibility was defined a priori as 70% completion rates. Acceptability was defined quantitatively (satisfaction scores) and qualitatively (open-ended questions regarding experience with program). Preliminary outcomes were assessed with preprogram and post program assessments of self-reported resilience, stress, anxiety, and burnout using validated instruments. Descriptive statistics summarized demographic variables and feasibility and acceptability. Linear mixed effects regression models examined preliminary outcomes, controlling for relevant covariates. Results: A total of 153 participants (median [SD] age, 40.6 [10.1] years; 142 [92%] were female; 128 [84%] identified as having White race; 81 [53%] were in patient-facing roles) enrolled. Of the 132 health care workers who provided follow-up surveys, 120 (91%) had completed the program, and 116 (88%) reported being satisfied. Answers to open-ended questions suggested that participants wanted more PRISM either with longer or additional sessions. Participant-reported resilience (ß = 1.74; 95% CI, 1.00-2.48), stress (ß = -2.40; 95% CI, -3.28 to -1.51), anxiety (ß = -2.04; 95% CI, -2.74 to -1.34), and burnout-exhaustion (ß = -0.37; 95% CI, -0.56 to -0.18) improved after the program. Conclusions and Relevance: Results of this study suggest that PRISM at Work may have utility for health care workers and staff in that the program was found to be feasible, acceptable, and associated with improved outcomes.


Subject(s)
Burnout, Professional , COVID-19 , Resilience, Psychological , Adolescent , Adult , Burnout, Professional/prevention & control , COVID-19/epidemiology , Female , Hospitals , Humans , Male , Pandemics , Personnel, Hospital , Pilot Projects , Stress, Psychological/psychology , Young Adult
18.
Viruses ; 14(6)2022 06 14.
Article in English | MEDLINE | ID: covidwho-1911635

ABSTRACT

Healthcare workers (HCWs) are known to be at higher risk of developing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections although whether these risks are equal across all occupational roles is uncertain. Identifying these risk factors and understand SARS-CoV-2 transmission pathways in healthcare settings are of high importance to achieve optimal protection measures. We aimed to investigate the implementation of a voluntary screening program for SARS-CoV-2 infections among hospital HCWs and to elucidate potential transmission pathways though phylogenetic analysis before the vaccination era. HCWs of the University Hospital of Liège, Belgium, were invited to participate in voluntary reverse transcriptase-polymerase chain reaction (RT-PCR) assays performed every week from April to December 2020. Phylogenetic analysis of SARS-CoV-2 genomes were performed for a subgroup of 45 HCWs. 5095 samples were collected from 703 HCWs. 212 test results were positive, 15 were indeterminate, and 4868 returned negative. 156 HCWs (22.2%) tested positive at least once during the study period. All SARS-CoV-2 test results returned negative for 547 HCWs (77.8%). Nurses (p < 0.05), paramedics (p < 0.05), and laboratory staff handling respiratory samples (p < 0.01) were at higher risk for being infected compared to the control non-patient facing group. Our phylogenetic analysis revealed that most positive samples corresponded to independent introduction events into the hospital. Our findings add to the growing evidence of differential risks of being infected among HCWs and support the need to implement appropriate protection measures based on each individual's risk profile to guarantee the protection of both HCWs and patients. Furthermore, our phylogenetic investigations highlight that most positive samples correspond to distinct introduction events into the hospital.


Subject(s)
COVID-19 , Belgium/epidemiology , COVID-19/diagnosis , COVID-19/epidemiology , Delivery of Health Care , Health Personnel , Hospitals, University , Humans , Personnel, Hospital , Phylogeny , SARS-CoV-2/genetics
19.
BMC Health Serv Res ; 22(1): 818, 2022 Jun 24.
Article in English | MEDLINE | ID: covidwho-1902388

ABSTRACT

OBJECTIVE: Hospital sanitary workers are among the prime source to disseminate information at a massive level, however they received least attention during the pandemic COVID-19. The study was designed to investigate the prevailing myths and misconceptions of the coronavirus pandemic among the sanitary workers of health care system. Further, a systematic training program is devised and tested to demystify the false myths with discerning truth and awareness-raising in hospital sanitary workers. METHOD: A pre-post face-to-face intervention design was opted and the intervention was conducted at five locations by the project team. The intervention consisted a 3 days training program to target myths and misconceptions of hospital sanitary workers. The study was completed in 8 months starting from August, 2019 to March, 2020. Participants were recruited from local hospitals having a specialized indoor COVID treatment facility. The sample consisted of 82 participants (n = 25, 30.09% females) with age ranging from 18 to 60 years (M ± SD = 37.41 ± 10.09). FINDINGS: The results indicated that 86.4% of the participants never heard the name of the coronavirus before the pandemic in Pakistan. A majority of the participants (> 50%) believed on a very alarming but unrealistic rate of mortality i.e., 30-60%. The pre-testing showed a high prevalence of myths in all four domains (i.e., popular treatments = 24.44, conspiracy myths = 7.93, home remedies = 16.46, and COVID-reliance = 7.82). The pre and post comparison of individual myths showed significant improvement on 24 of the 26 myths with a decline ranging from 0.18 to 1.63. Overall, the intervention significantly decreased scores on all four domains of coronavirus myths. CONCLUSION: The training intervention appeared to effectively reduce myths and misconceptions of sanitary staff workers and is advised to be included as a standard training program for sanitary workers of health care system.


Subject(s)
COVID-19 , Adolescent , Adult , COVID-19/epidemiology , COVID-19/prevention & control , Female , Health Personnel , Hospitals , Humans , Male , Middle Aged , Pakistan/epidemiology , Pandemics/prevention & control , Personnel, Hospital , Young Adult
20.
BMJ Open Qual ; 11(2)2022 06.
Article in English | MEDLINE | ID: covidwho-1891845

ABSTRACT

BACKGROUND: The COVID-19 pandemic has required urgent organisational and managerial adaptation, with hospital medical and administrative leaders under considerable pressure. METHODS: At a single French university hospital, we performed a sociological analysis of management adaptation by medical and administrative leaders during the first wave of the COVID-19 crisis. Two sociologists performed interviews with representative members of staff from all the structures involved in managing the crisis to analyse adaptation and the solutions found during this period. RESULTS: The answers collected during interviews were classified into three main topics describing the organisational adaptations of the hospital staff during the COVID-19 crisis: (1) exceptional mobilisation and collaboration; (2) crisis management based primarily on the principle of subsidiarity; and (3) survival of the administrative structure with interventions to support caregivers. CONCLUSION: This study, focusing on a single hospital, identified a number of factors associated with successful mobilisation in the very specific conditions of this viral pandemic.


Subject(s)
COVID-19 , Hospitals, University , Humans , Pandemics , Personnel, Hospital
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