ABSTRACT
BACKGROUND: Healthcare-acquired COVID-19 has been an additional burden on hospitals managing increasing numbers of patients with SARS-CoV-2. One acute hospital (W) among three in a Scottish healthboard experienced an unexpected surge of COVID-19 clusters. AIM: To investigate possible causes of COVID-19 clusters at Hospital W. METHODS: Daily surveillance provided total numbers of patients and staff involved in clusters in three acute hospitals (H, M and W) and care homes across the healthboard. All clusters were investigated and documented, along with patient boarding, community infection rates and outdoor temperatures from October 2020 to March 2021. Selected SARS-CoV-2 strains were genotyped. FINDINGS: There were 19 COVID-19 clusters on 14 wards at Hospital W during the six-month study period, lasting from two to 42 days (average, five days; median, 14 days) and involving an average of nine patients (range 1-24) and seven staff (range 0-17). COVID-19 clusters in Hospitals H and M reflected community infection rates. An outbreak management team implemented a control package including daily surveillance; ward closures; universal masking; screening; restricting staff and patient movement; enhanced cleaning; and improved ventilation. Forty clusters occurred across all three hospitals before a January window-opening policy, after which there were three during the remainder of the study. CONCLUSION: The winter surge of COVID-19 clusters was multi-factorial, but clearly exacerbated by moving trauma patients around the hospital. An extended infection prevention and control package including enhanced natural ventilation helped reduce COVID-19 clusters in acute hospitals.
Subject(s)
COVID-19 , Delivery of Health Care , Hospitals , Humans , SARS-CoV-2 , Scotland/epidemiologyABSTRACT
The Developmental Behavior Checklist (DBC; Einfeld & Tonge, 1995) is one of a very small number of psychopathology assessment instruments designed specifically for use with children and adolescents with mental retardation. In the present study, a factor analysis of the DBC was performed using a sample of 531 children and adolescents. This analysis revealed a factor structure sharing a good deal of overlap with the factor analyses of the DBC's developers. Furthermore, the high levels of internal consistency of the DBC subscales were replicated. Further research and development is needed on the DBC and other instruments for children and adolescents with mental retardation.
Subject(s)
Child Behavior Disorders/diagnosis , Child Behavior Disorders/etiology , Intellectual Disability/psychology , Adolescent , Child , Child, Preschool , Female , Humans , Male , Psychometrics , Reproducibility of ResultsABSTRACT
BACKGROUND: For several decades, researchers and clinicians have been aware of an increased prevalence of psychiatric disorder in children with intellectual disability. However, there are few research studies exploring this issue. METHODS: The parents of 123 children attending schools for children with 'severe learning difficulties' completed the Developmental Behaviour Checklist (DBC) in order to identify those children with clinically significant behavioural and emotional problems. Comparisons were made with norms for the DBC and a range of child variables were investigated as possible correlates of disorder. RESULTS: Some 50.4% of the children scored above the cut-off on the DBC for psychiatric disorder. The child's severity of physical disability was related most strongly to parental ratings of behavioural and emotional problems. There were also effects for the child's age and the absence of Down's syndrome. CONCLUSIONS: The present study confirms previous research findings of a high prevalence of behavioural and emotional difficulties amongst children with intellectual disability, and identifies a number of correlates of disorder which require further investigation.
Subject(s)
Child Behavior Disorders/complications , Child Behavior Disorders/epidemiology , Education, Special , Intellectual Disability/complications , Mood Disorders/complications , Mood Disorders/epidemiology , Students , Adolescent , Child , Child Behavior Disorders/diagnosis , Child, Preschool , Female , Humans , Male , Mood Disorders/diagnosis , Prevalence , Reproducibility of Results , Severity of Illness Index , Surveys and QuestionnairesABSTRACT
Since practising anaesthetic nursing the author discovered much time and energy can be wasted if the patient checklist and handover from the ward is not completed correctly. Her colleagues expressed similar frustrations at various problems faced daily, that could be easily avoided by actions earlier on in the patients' management.
