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Multidimensional dynamic healthcare personnel (HCP)-centric model from a low-income and middle-income country to support and protect COVID-19 warriors: a large prospective cohort study.
Dutta, Usha; Sachan, Anurag; Premkumar, Madhumita; Gupta, Tulika; Sahoo, Swapnajeet; Grover, Sandeep; Sharma, Sugandhi; Lakshmi, P V M; Talati, Shweta; Biswal, Manisha; Suri, Vikas; Singh, Mini P; Ghai, Babita; Chhabra, Rajesh; Bharti, Bhavneet; Samanta, Jayanta; Arora, Pankaj; Mohindra, Ritin; Malhotra, Sunita; Singh, Gurmeet; Guru, Rashmi Ranjan; Pandey, Navin; Koushal, Vipin; Kumar, Ashok; Bhogal, Ranjitpal Singh; Aggarwal, Arun K; Goel, Kapil; Malhotra, Pankaj; Yaddanapudi, Narayana; Mahajan, Pranay; Thakur, J S; Sehgal, Rakesh; Ghosh, Arnab; Sehgal, Inderpaul Singh; Agarwal, Ritesh; Jayashree, Muralidharan; Bhalla, Ashish; Jain, Sanjay; Kochhar, Rakesh; Chakrabarti, Arunaloke; Puri, Goverdhan Dutt; Ram, Jagat.
  • Dutta U; Department of Gastroenterology, PGIMER, Chandigarh, India ushadutta@gmail.com.
  • Sachan A; Department of Gastroenterology, PGIMER, Chandigarh, India.
  • Premkumar M; Department of Gastroenterology, PGIMER, Chandigarh, India.
  • Gupta T; Department of Hepatology, PGIMER, Chandigarh, India.
  • Sahoo S; Department of Anatomy, PGIMER, Chandigarh, India.
  • Grover S; Department of Psychiatry, PGIMER, Chandigarh, India.
  • Sharma S; Department of Psychiatry, PGIMER, Chandigarh, India.
  • Lakshmi PVM; Department of Community Medicine and School of Public Health, PGIMER, Chandigarh, India.
  • Talati S; Department of Community Medicine and School of Public Health, PGIMER, Chandigarh, India.
  • Biswal M; Department of Hospital Administration, PGIMER, Chandigarh, India.
  • Suri V; Department of Microbiology, PGIMER, Chandigarh, India.
  • Singh MP; Department of Internal Medicine, PGIMER, Chandigarh, India.
  • Ghai B; Department of Virology, PGIMER, Chandigarh, India.
  • Chhabra R; Department of Anesthesia, PGIMER, Chandigarh, India.
  • Bharti B; Department of Neurosurgery, PGIMER, Chandigarh, India.
  • Samanta J; Department of Pediatrics, PGIMER, Chandigarh, India.
  • Arora P; Department of Gastroenterology, PGIMER, Chandigarh, India.
  • Mohindra R; Department of Hospital Administration, PGIMER, Chandigarh, India.
  • Malhotra S; Department of Internal Medicine, PGIMER, Chandigarh, India.
  • Singh G; Department of Internal Medicine, PGIMER, Chandigarh, India.
  • Guru RR; Department of Dietetics, PGIMER, Chandigarh, India.
  • Pandey N; Department of Community Medicine and School of Public Health, PGIMER, Chandigarh, India.
  • Koushal V; Department of Hospital Administration, PGIMER, Chandigarh, India.
  • Kumar A; Department of Hospital Administration, PGIMER, Chandigarh, India.
  • Bhogal RS; Department of Hospital Administration, PGIMER, Chandigarh, India.
  • Aggarwal AK; Department of Hospital Administration, PGIMER, Chandigarh, India.
  • Goel K; Department of Hospital Administration, PGIMER, Chandigarh, India.
  • Malhotra P; Department of Community Medicine and School of Public Health, PGIMER, Chandigarh, India.
  • Yaddanapudi N; Department of Community Medicine and School of Public Health, PGIMER, Chandigarh, India.
  • Mahajan P; Department of Internal Medicine, PGIMER, Chandigarh, India.
  • Thakur JS; Department of Anesthesia, PGIMER, Chandigarh, India.
  • Sehgal R; Department of Hospital Administration, PGIMER, Chandigarh, India.
  • Ghosh A; Department of Community Medicine and School of Public Health, PGIMER, Chandigarh, India.
  • Sehgal IS; Department of Parasitology, PGIMER, Chandigarh, India.
  • Agarwal R; Department of Virology, PGIMER, Chandigarh, India.
  • Jayashree M; Department of Pulmonology, PGIMER, Chandigarh, India.
  • Bhalla A; Department of Pulmonology, PGIMER, Chandigarh, India.
  • Jain S; Department of Pediatrics, PGIMER, Chandigarh, India.
  • Kochhar R; Department of Internal Medicine, PGIMER, Chandigarh, India.
  • Chakrabarti A; Department of Internal Medicine, PGIMER, Chandigarh, India.
  • Puri GD; Department of Gastroenterology, PGIMER, Chandigarh, India.
  • Ram J; Department of Microbiology, PGIMER, Chandigarh, India.
BMJ Open ; 11(2): e043837, 2021 02 22.
Article in English | MEDLINE | ID: covidwho-1096994
ABSTRACT

OBJECTIVES:

Healthcare personnel (HCP) are at an increased risk of acquiring COVID-19 infection especially in resource-restricted healthcare settings, and return to homes unfit for self-isolation, making them apprehensive about COVID-19 duty and transmission risk to their families. We aimed at implementing a novel multidimensional HCP-centric evidence-based, dynamic policy with the objectives to reduce risk of HCP infection, ensure welfare and safety of the HCP and to improve willingness to accept and return to duty.

SETTING:

Our tertiary care university hospital, with 12 600 HCP, was divided into high-risk, medium-risk and low-risk zones. In the high-risk and medium-risk zones, we organised training, logistic support, postduty HCP welfare and collected feedback, and sent them home after they tested negative for COVID-19. We supervised use of appropriate personal protective equipment (PPE) and kept communication paperless.

PARTICIPANTS:

We recruited willing low-risk HCP, aged <50 years, with no comorbidities to work in COVID-19 zones. Social distancing, hand hygiene and universal masking were advocated in the low-risk zone.

RESULTS:

Between 31 March and 20 July 2020, we clinically screened 5553 outpatients, of whom 3012 (54.2%) were COVID-19 suspects managed in the medium-risk zone. Among them, 346 (11.4%) tested COVID-19 positive (57.2% male) and were managed in the high-risk zone with 19 (5.4%) deaths. One (0.08%) of the 1224 HCP in high-risk zone, 6 (0.62%) of 960 HCP in medium-risk zone and 23 (0.18%) of the 12 600 HCP in the low-risk zone tested positive at the end of shift. All the 30 COVID-19-positive HCP have since recovered. This HCP-centric policy resulted in low transmission rates (<1%), ensured satisfaction with training (92%), PPE (90.8%), medical and psychosocial support (79%) and improved acceptance of COVID-19 duty with 54.7% volunteering for re-deployment.

CONCLUSION:

A multidimensional HCP-centric policy was effective in ensuring safety, satisfaction and welfare of HCP in a resource-poor setting and resulted in a willing workforce to fight the pandemic.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Infectious Disease Transmission, Patient-to-Professional / COVID-19 / Medical Staff, Hospital / Occupational Diseases Type of study: Cohort study / Observational study / Prognostic study Limits: Adult / Female / Humans / Male Language: English Journal: BMJ Open Year: 2021 Document Type: Article Affiliation country: Bmjopen-2020-043837

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Infectious Disease Transmission, Patient-to-Professional / COVID-19 / Medical Staff, Hospital / Occupational Diseases Type of study: Cohort study / Observational study / Prognostic study Limits: Adult / Female / Humans / Male Language: English Journal: BMJ Open Year: 2021 Document Type: Article Affiliation country: Bmjopen-2020-043837