Perceptions of antibiotic resistance among hospital healthcare professionals in high-income countries: A systematic review of causes, consequences, and solutions.

OBJECTIVE: Antibiotic resistance (ABR) is a major threat to public health. Hospital healthcare professionals are important stakeholders in curbing ABR. To be able to encourage healthcare professionals to act against ABR, information on their perceptions is needed. Yet, summary evidence on how healthcare professionals perceive ABR causes, consequences, and solutions is outdated. This review aims to elucidate these perceptions. METHODS: We searched MEDLINE, EMBASE, PsycINFO, and CINAHL for literature published until July 6th, 2022, and used Web of Science and Scopus to identify reports citing included studies. Reports of quantitative original research from high-income countries were included if they investigated hospital healthcare professionals' perceptions about ABR. Descriptive data and data on perceptions about causes, consequences, and solutions regarding ABR were extracted. PROSPERO registration: CRD42022359249. RESULTS: The database search and citation tracking yielded 13,551 and 694 papers respectively. Forty-eight reports from 46 studies were included in the review. These studies were performed between 1999 and 2023 and included between 8 and 1362 participants. Healthcare professionals perceived ABR as a problem that is more severe nationally than locally and they primarily recognize ABR as a distant and abstract problem. Studies mostly concurred on prescribing behavior as a cause and a solution for ABR, while external causes and solutions (e.g., in agriculture) elicited less agreement. CONCLUSIONS: Studies with a primary focus on the perceptions of healthcare professionals about ABR are limited. Healthcare professionals perceive prescribing behavior as a major cause of ABR and a focus area for ABR solutions.

Implementing Longitudinal Wellbeing Interventions and Evaluation Among Midwestern Healthcare Workers During COVID-19.

BACKGROUND: The impact of the COVID-19 pandemic on the mental health of healthcare workers throughout the world has been reported, but most studies have been cross-sectional and excluded the Midwestern U.S. healthcare workforce. OBJECTIVE: This study aimed to longitudinally assess the psychological wellbeing and wellness strategies used by a Midwestern academic health system's workforce at multiple points throughout waves of the COVID-19 pandemic to inform ongoing implementation of appropriate wellness activities. METHODS: An anonymous REDCap survey linked within our team-developed wellness education was posted in the employee online newsletter in April (T1), July (T2), October 2020 (T3), and May 2021 (T4). Surveys were open to all employees (approx. 9000) for approximately 12 days at each time point. Anxiety, depressive symptoms, stress, self-efficacy, and self-care activities were assessed. Following each data collection, team members discussed findings and planned wellness education implementation. RESULTS: Response ranged from n = 731 (T1) to n = 172 (T4). Moderate to severe stress was reported by 29.5% (n = 203) of respondents at T1 and 34.0% (n = 108) at T2. At T3, all psychological symptoms significantly increased (p < .001) as COVID-19 surged, with 48.5% (n = 141) of respondents reporting moderate to severe stress. At T4, stress significantly declined (p < .001). Exercise was the most frequently reported coping strategy. CONCLUSIONS: Mental health symptoms reported by a Midwestern healthcare workforce increased during surges of COVID-19 hospitalizations. Individuals in non-patient contact roles experienced symptom levels similar to and at times with greater severity than healthcare personnel with patient contact roles.

Coping with the hospital environment during the COVID-19 pandemic: A qualitative study of the survivors' perspective during their stay at the ICU and inpatient ward.

The COVID-19 pandemic has significantly affected the clinical practice of healthcare professionals. This study aimed to explore the perspectives of COVID-19 survivors regarding the healthcare they received during their stay in the Intensive Care Unit (ICU) and the inpatient COVID-19 ward. A qualitative case-study approach was implemented. Participants were recruited using non-probabilistic purposeful sampling strategy. Inclusion criteria included patients aged ≥18 years who received follow-up from the Pulmonology service at a Hospital in de North of Spain, were diagnosed with COVID-19 and bilateral pneumonia, and were admitted to the ICU before being transferred to a COVID-19 inpatient ward. Data was collected through in-depth interviews and researchers' field notes, and thematic analysis was performed. Techniques such as credibility, transferability, dependability, and confirmability were employed to ensure the trustworthiness of the data. A total of 25 individuals (six women) were included in the study. Three main themes emerged from the analysis: common challenges faced in both units, coping with the hospital stay, and developing strategies. Findings highlighted the need to improve information dissemination, individualize care, and enhance direct patient interaction. Moreover, the study shed light on the psychological impact of hospitalization and ICU experience, including feelings of loneliness, confinement, and the lack of memories from the ICU stay, as well as the influence of care and healthcare language. Finally, strategies such as keeping the mind occupied and maintaining self-discipline were identified as crucial during hospitalization. These findings provide valuable insights for healthcare professionals in delivering care to individuals with COVID-19 in the ICU and hospital ward settings.

Components of hospital personnel preparedness to evacuate patients in disasters: a systematic review.

BACKGROUND: During natural catastrophes, hospital staff members' readiness for crisis management-particularly concerning patient evacuation and improving their safety-becomes paramount. This study aimed to identify the components contributing to hospital staff members' preparedness to evacuate patients in an emergency. METHOD: A systematic review was conducted by searching databases such as Scopus, Web of Science, PubMed, ProQuest, and grey literature through May 2023. Studies that offered unique qualitative or quantitative data regarding hospital personnel readiness to evacuate patients in an emergency were included. Thematic analysis and descriptive statistics were used to examine the extracted data points. RESULTS: In total, there were 274 scientific articles. The total number of unique studies decreased to 181 after removing duplicate articles. 28 papers that were deemed appropriate for additional study were found based on the titles and abstracts of these articles. Eighteen papers that met the inclusion criteria were selected for the systematic review after their entire texts were finally assessed. Hospital staff preparedness for patient evacuation was divided into four primary topics and nineteen sub-themes. The four primary themes that emerged were management, communication, individual issues, and training on the evacuation process. CONCLUSION: The implementation of proper disaster evacuation training programs can be achieved by elevating the perceived sensitivity and protective motive of personnel and considering the personnel's stages of change. Training hospital staff to properly evacuate patients during disasters is also significantly impacted by other factors, such as effective administration, leadership and prompt and efficient communication.

Assessment of quality of life, job insecurity and work ability among nurses, working either under temporary or permanent terms.

OBJECTIVES: Aim of this study was to assess and compare health, quality of life, well-being, job satisfaction and job insecurity between nurses, in a tertiary hospital in Greece, working either under permanent or temporary contract. MATERIAL AND METHODS: In this cross-sectional study, consecutively recruited nurses answered a structured questionnaire, the WHO-5 Well-being Index (WHO-5), the Job Insecurity Index (JII), the Work Ability Index (WAI), and the Well-Being at Work Scale (WBWS). RESULTS: Included were 323 nurses (87.6% women, age M±SD 43.68±8.10 years). Tem- porary contract employees had worse quality of life (p = 0.009) and higher job insecurity: both in cognitive dimension (p = 0.013) and emotional dimension (p < 0.001). They also scored worse in the positive affect (p < 0.001), negative affect (p = 0.002) and fulfillment of expectations in work environment (p < 0.001) domains of the WBWS. Additionally, they reported less frequently occupational accidents and injuries (p = 0.001), muscu - loskeletal disorders of the spine or neck (p = 0.007), cardiovascular (p = 0.017), and gastrointestinal (p = 0.010) disorders, while they reported more frequently mental disorders (p < 0.001). Multivariate linear regression analysis showed that temporary work predicted high cognitive (p = 0.010) and emotional (p < 0.001) insecurity, low positive emotions and mood index (p = 0.007), low achievement-fulfillment index (p = 0.047) and high index of negative emotions (p = 0.006), regardless of gender and age. CONCLUSIONS: Temporary employment among nurses is associated with a lower sense of job security and well-being, and a higher prevalence of mental disorders, independently of age or gender without a significantly negative effect on their ability to work. Managers, as well as occupational physicians, should recognize the extent of nurses' job insecurity and assess their ability to work, to provide them with the necessary support and to stimulate the sense of occupational security and work capacity, so that they can thrive in their workplace and therefore be more productive and provide high quality healthcare. Int J Occup Med Environ Health. 2024;37(1):98-109.

Educational intervention based on health action model to promote safe behavior of hospital service workers.

BACKGROUND: Hospitals are considered to be one of the most hazardous environments to work in, and their service workers are exposed to many serious risks. So The purpose of this study was to investigate the effect of educational intervention based on the Health Action Model to promote the safe behavior of hospital service workers. METHODS: In this quasi-experimental study, 45 workers in each of the control and experimental groups participated. Demographic information and data related to Health Action Model constructs were collected through a questionnaire and a checklist, immediately and three months after the intervention. Cronbach's alpha coefficients were used to confirm the properties of the tools. Educational intervention accompanied was applied in the form of four training classes. The data were analyzed using SPSS 20 software. RESULTS: Before the intervention, there was no significant difference between the two groups in terms of demographics and the study's main variables. results showed significant changes in mean scores of safe behavior, Attitude, norms, belief, intention, knowledge in the experimental group three months after the intervention (P < 0.001). CONCLUSIONS: The research results show that Health Action Model educational intervention can change workers' awareness, attitudes, norms, beliefs, and intentions toward unsafe behavior and improve their safety performance. TRIAL REGISTRATION: IRCTID: IRCT20160619028529N7.

From Hospital to Community: Exploring Antibiotic Resistance and Genes Associated with Virulence Factor Diversity of Coagulase-Positive Staphylococci.

Coagulase-positive staphylococcus (CoPS), including methicillin-resistant Staphylococcus aureus (MRSA), poses a global threat. The increasing prevalence of MRSA in Saudi Arabia emphasizes the need for effective management. This study explores the prevalence of virulence-associated genes and antibiotic resistance patterns in CoPS. Nasal swabs from 200 individuals were collected, and standard protocols were used for the isolation, identification, and characterization of CoPS and coagulase-negative staphylococci (CoNS). Additionally, antimicrobial susceptibility testing and PCR were conducted. Bacterial growth was observed in 58.5% of participants, with 12% positive for CoPS and 30% positive for CoNS. Hospital personnel carriers showed a significantly higher proportion of CoNS compared with non-hospital personnel carriers. Non-hospital personnel CoPS strains displayed higher sensitivity to oxacillin than hospital personnel strains. Cefoxitin exhibited the highest sensitivity among ß-lactam antibiotics. All isolates were sensitive to trimethoprim/sulfamethoxazole, rifampin, and quinupristin. Polymerase chain reaction analysis detected methicillin resistance genes in both non-hospital and hospital personnel MRSA strains. The coa and spa genes were prevalent in MRSA isolates, while the Luk-PV gene was not detected. A high prevalence of CoPS and CoNS was observed in both non-hospital and hospital personnel carriers. Occupational risk factors may contribute to the differences in the strain distribution. Varying antibiotic susceptibility patterns indicate the effectiveness of oxacillin and cefoxitin. Urgent management strategies are needed due to methicillin resistance. Further research is necessary to explore additional virulence-associated genes and develop comprehensive approaches for CoPS infection prevention and treatment in Saudi Arabia.

[Administrative burden, motivation and well-being among primary care physicians: comparison of management models]. / Carga administrativa, motivación y bienestar entre médicos de atención primaria. Comparación entre modelos de gestión.

OBJECTIVE: To analyze the relationship between administrative burden and intrinsic motivation and between administrative burden and professional well-being among family and community medicine physicians. To analyze the extent to which attention to three basic needs (autonomy, sense of competence and relationship capacity) that one of the main motivation theories identifies as a generator of intrinsic motivation compensates for the negative effect of the administrative burden. To compare management models. METHOD: Data from a survey (542 valid questionnaires) carried out through the Catalan Society of Family and Community Medicine are used. Data analysis is based on multiple regression and ANOVA techniques. RESULTS: The perception of administrative burden and "red tape" are clearly demotivating and reduce job satisfaction. On the contrary, individual autonomy, networking opportunities between professionals and performance feedback are motivating and feed the perception of professional well-being. The EBA (Association Based Entity) model presents results above the ICS (Catalan Health Institute) and OSI (Integrated Health Organizations) models both in controlling the negative effect of administrative burden and in the management of basic psychological needs. CONCLUSIONS: The motivation and professional well-being of primary care physicians would benefit from reforms that limit the administrative burden of some procedures and red tape. At the primary health center level, greater attention to individual autonomy, improving relatedness between professionals and the sense of competence based on better information on individual performance can offset the negative effects of the administrative burden.

The effect of the hospital working environment on the work limitation of the employees in Turkey: a multivariable analysis.

BACKGROUND: The aim of this study is to examine the effects of working environment and demographic variables on the level of work limitation in a university hospital. METHODS: The study is cross-sectional and was conducted in 2022 among employees of a university hospital. 254 people voluntarily participated in the study. Data were collected by applying the sociodemographic data form, the Work Limitation Questionnaire (WLQ), and the Work Environment Scale (WES). Institutional permission and ethical approval were obtained for the study. In the analysis of the data, t-test, ANOVA, and linear regression (LR) were used. RESULTS: The WLQ score average of hospital staff was low. According to LR analysis, the factors affecting the level of work limitation of hospital staff; worsening perception of health status, being a doctor, decreased income level, increased working time in the institution, and age reduction. It was determined that 32.8% of the change in the WLQ score was related to these factors. While in the univariate tests, the mean of work limitation was found to be significant by getting occupational health safety training, having health problems due to the work done, and taking leave due to work accidents, in the multivariable LR analysis, these factors were insignificant. CONCLUSIONS: As the working environment gets worse, the level of work limitation increases. It is recommended that hospital managers make the working environment better and safer, and make arrangements and programs to increase personnel satisfaction.

Experiences, risk perceptions, and COVID-19 vaccination outcomes among hospital workers.

BACKGROUND: Although COVID-19 vaccinations have been available to hospital workers in the U.S. since December 2020, coverage is far from universal, even in groups with patient contact. The aim of this study was to describe COVID-19-related experiences at work and in the personal lives of nurses, allied health workers, and non-clinical staff with patient contact, and to assess whether these experiences relate to COVID-19 vaccination. METHODS: Health care workers at a large Midwestern hospital in the U.S. were contacted to participate in an online cross-sectional survey during February 2021. A logistic regression model was used to estimate odds ratios (OR) for vaccination by different experiences, and we assessed mediation through models that also included measures of risk perceptions. RESULTS: Among 366 nurse practitioners / nurse midwives / physician assistant, 1,698 nurses, 1,798 allied health professionals, and 1,307 non-clinical staff with patient contact, the proportions who had received or intended to receive a COVID-19 vaccination were 94 %, 87 %, 82 %, and 88 %, respectively. Working and being physically close to COVID-19 patients was not significantly associated with vaccine intent. Vaccination intent was significantly lower among those with a previous COVID-19 diagnosis vs not (OR = 0.33, 95 % CI: 0.27, 0.40) and higher for those who knew close family members of friends hospitalized or died of COVID-19 (OR = 1.33, 95 % CI: 1.10, 1.60). CONCLUSION: Even when COVID-19 vaccination was available in February 2021, a substantial minority of hospital workers with patient contact did not intend to be vaccinated. Moreover, their experiences working close to COVID-19 patients were not significantly related to vaccination intent. Instead, personal experiences with family members and friends were associated with vaccination intent through changes in risk perceptions. Interventions to increase uptake among hospital workers should emphasize protection of close family members or friends and the severity of COVID-19.

Descriptive analysis of a SARS-CoV-2 outbreak among health-care workers in a regional hospital in the Philippines

@#Objective: On 25 July 2022, trainees from the Field Epidemiology Training Programme in Northern Luzon, Philippines were sent to conduct an epidemiological investigation of six confirmed cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among staff of a regional hospital in Mountain Province. The investigation had three objectives: to profile the cases, identify the source and mode of transmission, and recommend prevention and control measures. Methods: Descriptive epidemiology was used to investigate the outbreak, with the standard case definition issued by the Philippine Department of Health. Results: A total of 167 hospital personnel and interns tested positive for SARS-CoV-2 infection between 6 July and 31 August 2022, with a peak in the number of cases on 20 July. Among the cases, 57 (34%) had a history of travel, with 41 (25%) having travelled to Boracay island to attend team-building activities. Most cases were asymptomatic, and the most affected group was those aged 30–34 years. The highest number of cases occurred among nurses. It was discovered that the team-building activities on Boracay did not strictly adhere to safety protocols. Discussion: This outbreak suggests that transmission of SARS-CoV-2 among health-care workers can occur through contact with other staff members outside of the hospital setting and highlights the importance of strict adherence to safety protocols to prevent the spread of SARS-CoV-2.

Resilience levels among Filipino non-medical personnel at a Tertiary Government Hospital in Metro Manial during the COVID-19 Pandemic - July 2021

Objectives@#This study aimed to measure the resilience level of non-medical personnel of the University of the Philippines Manila – Philippine General Hospital (UP-PGH) and determine whether this was associated with sociodemographic factors such as gender, length of service and job position.@*Methodology@#A cross-sectional study that included non-medical personnel using convenience sampling via email was done. Data was obtained through the 14-item Resilience Scale (RS-14) as well as a sociodemographic factors questionnaire. Descriptive and non-parametric correlational analysis of data was used.@*Results@#One hundred twenty five of the 153 respondents (81.70%) garnered a resilience score of 74-98 or moderate to high resilience level, while 28 or 18.30% had a resilience score corresponding to very low and on the low end. The mean resilience score was 81.8, corresponding to a moderate resilience level. More women than men had a resilience level of moderate to high. Respondents with greater than 5 years of work experience within the hospital had higher resilience levels than those who were less experienced. Moderate to high resilience levels were found in more administrative than non-administrative personnel. No significant association was found between resilience level and the factors analyzed. In terms of Resilience Core Characteristics, all comparisons between demographic factors of interest and Self-reliance, Purpose, Equanimity, Perseverance and Authenticity yielded insignificant results except for Self-reliance versus length of service, which showed a weak but significant relationship. Exploratory factor analysis found that the unidimensionality of the RS-14 Scale (US Version) still applied when administered to Filipinos in this particular population.@*Conclusion@#Majority of the non- medical personnel of the UP -PGH had moderate level of resilience. There was a lack of significant association between resilience level and demographic characteristics like age, length of service, and position in the study sample. In terms of Resilience Core Characteristics, comparison between length of service and self -reliance showed a weak but significant relationship.

Carga administrativa, motivación y bienestar entre médicos de atención primaria. Comparación entre modelos de gestión / Administrative burden, motivation and well-being among primary care physicians: comparison of management models

Objetivo: Analizar la relación entre carga administrativa y motivación intrínseca y entre carga administrativa y bienestar profesional en los médicos especialistas en medicina familiar y comunitaria. Analizar en qué medida la atención a tres necesidades básicas (autonomía, sentido de competencia y capacidad de relación) que una de las principales teorías de la motivación identifica como generadora de motivación intrínseca compensa el efecto negativo de la carga administrativa y comparar modelos de gestión. Método: Se utilizan datos de una encuesta (542 cuestionarios válidos) realizada a través de la Sociedad Catalana de Medicina Familiar y Comunitaria. El análisis de los datos se fundamenta en las técnicas de regresión múltiple y ANOVA. Resultados: La percepción de carga administrativa y de papeleo inútil (red tape) es claramente desmotivadora y disminuye la satisfacción en el trabajo. Por el contrario, la autonomía individual, las oportunidades de relación entre profesionales y el feedback sobre rendimiento son motivadores y alimentan la percepción de bienestar profesional. El modelo EBA (entidades de base asociativa) presenta resultados por encima de los modelos ICS (Instituto Catalán de la Salud) y OSI (organizaciones sanitarias integradas) tanto en el control del efecto negativo de las cargas administrativas como en la gestión de las necesidades psicológicas básicas. Conclusiones: La motivación y el bienestar profesional de los médicos de atención primaria se verían beneficiados por reformas que limiten la carga administrativa de algunos trámites y el papeleo con una baja funcionalidad. A nivel de gestión de los centros, una mayor atención a la autonomía individual, a la capacidad de relación entre profesionales y al sentido de competencia sobre la base de una mejor información sobre el rendimiento individual puede compensar los efectos negativos de la carga administrativa.(AU)

Objective: To analyze the relationship between administrative burden and intrinsic motivation and between administrative burden and professional well-being among family and community medicine physicians. To analyze the extent to which attention to three basic needs (autonomy, sense of competence and relationship capacity) that one of the main motivation theories identifies as a generator of intrinsic motivation compensates for the negative effect of the administrative burden. To compare management models. Method: Data from a survey (542 valid questionnaires) carried out through the Catalan Society of Family and Community Medicine are used. Data analysis is based on multiple regression and ANOVA techniques. Results: The perception of administrative burden and “red tape” are clearly demotivating and reduce job satisfaction. On the contrary, individual autonomy, networking opportunities between professionals and performance feedback are motivating and feed the perception of professional well-being. The EBA (Association Based Entity) model presents results above the ICS (Catalan Health Institute) and OSI (Integrated Health Organizations) models both in controlling the negative effect of administrative burden and in the management of basic psychological needs. Conclusions: The motivation and professional well-being of primary care physicians would benefit from reforms that limit the administrative burden of some procedures and red tape. At the primary health center level, greater attention to individual autonomy, improving relatedness between professionals and the sense of competence based on better information on individual performance can offset the negative effects of the administrative burden.(AU)

Nurses' perception of solutions proposed by nurse leaders in face of COVID-19 pandemic: A cross-sectional study.

AIM: To evaluate the perception of bedside nurses regarding the implementation of solutions proposed by nurse leaders for patient and employee care during the COVID-19 pandemic. BACKGROUND: Nurse leaders have proposed solutions to better manage the challenges of the pandemic. However, multiple factors influence the transposal of actions from the tactical to the operational levels. METHOD: This cross-sectional study was carried out in a 620-bed non-profit institution. Participants were bedside nurses who completed an online survey. RESULTS: One hundred sixty-eight nurses participated in the study. Most of the proposed solutions were very effective and easily identified by the nurses. These solutions included adaptations of the physical structure, availability of medical supplies and adequacy of institutional protocols. The actions that stood out with low perception were adequate integration of new employees and the availability of remote work, hotel accommodations for frontline health care workers and day care for children whose parents worked at the hospital. CONCLUSION: Bedside nurses were able to recognize most of the solutions proposed by their nurse leaders during the COVID-19 pandemic. IMPLICATIONS FOR NURSING MANAGEMENT: Tactical-level nurse leaders need constant proximity to bedside nurses and continuous elucidation of the objectives to be achieved by the strategies adopted.

The nature and pre-disposing factors of workplace violence: A qualitative study of how violence is experienced by ED personnel.

BACKGROUND: Workplace violence against emergency department (ED) personnel, especially nurses, is a growing global challenge, and it can have serious adverse impacts on the personnel's life and patient care. Investigating the experience of ED personnel can help healthcare authorities find the underlying factors causing violence and use proper strategies to prevent it. METHODS: In this qualitative exploratory study, data were collected using in-depth, face to face and semi-structured interviews with 20 ED personnel working in five hospitals in west Azerbaijan of Iran. The interviews were transcribed and transferred to MaxQda10 software for coding. Then, six steps conventional content analysis process proposed by Graneheim and Lundman (2004) was used to analyze the data. RESULTS: Two overarching categories of "perceived violence" and "predisposing factors of violence" were extracted from the data analysis. Perceived violence was supported by "verbal violence," "physical violence," "ethnic violence," and "sexual violence." The sub-categories of the "predisposing factors of violence included "inefficient management," "low professional competence of personnel," and " violent atmosphere." CONCLUSION: Concerning the high perceived experiences of violence in the ED, health care systems should take fundamental measures such as supporting the ED personnel, improving management, developing and implementing standard guidelines for triaging patients, conducting continuous educational courses on clinical knowledge and skills, and how to interact and communicate with clients would help prevent violence.

Measles immunity in medical center staff after changes in national and local hospital vaccination policies.

BACKGROUND: Measles vaccination was introduced in Taiwan in 1978, and the disease was declared eliminated in Taiwan in 2007. However, new cases have been reported unpredictably since then. Hospital medical staff are at particularly high risk for measles. We evaluated the immunity status of hospital medical staff after changes in national and local hospital vaccination policies. METHODS: This retrospective study was conducted in a tertiary care medical center from January 2008 to June 2018. Data were retrieved from all healthcare workers receiving employment medical examinations. Those with a full medical record including the geometrical mean titer (GMT) of anti-measles IgG were included. Age and sex differences in the GMT were analyzed by Student's t-tests and Chi-squared tests. Univariate and multivariate logistic regression analysis were used to determine the odds of immunity. RESULTS: The IgG positive rate increased with age group (p < 0.001). Seropositive rates for the birth before 1977 and after 1978 groups were 94.8% and 70.2% (p < 0.001). The odds ratio was also significantly different between both cohorts (1.000 vs. 0.423, p = 0.002). Staff in the examination department showed the lowest positive percentage of 70.3% (95% CI: 66.9-73.7%), whereas staff in preventive and long-term care services disclosed the highest positive percentage of 83.2% (95% CI: 76.1-90.2%). Subgroups 2015, 2017, and 2018 (p = 0.046, 0.046, 0.049), after the vaccination booster policy was launched, showed significant increases in seropositivity. CONCLUSIONS: Immunity efficacy is better in birth groups before 1977, which was highly related to natural infection before national policy launched. The policy of vaccination is an effective method, but medical staff attains inadequate protective antibody levels for maintenance of herd immunity. A pre-employment policy of screening a third booster vaccine of measles (or MMR) is recommended to lower the incidence of disease spreading and avoid outbreaks.

Organizational climate and interpersonal interactions among registered nurses in a neonatal intensive care unit: A qualitative study.

AIM: The aim of this work is to describe the organizational climate and interpersonal interactions experienced by registered nurses in a level III neonatal intensive care unit. BACKGROUND: Neonatal nurses have a demanding task in caring for a varied, highly vulnerable patient population and supporting patients' families. Nurses' psychosocial work environment affects quality of care as well as nurses' job satisfaction and organizational commitment. METHOD: Semistructured interviews with 13 nurses, covering numerous aspects of their psychosocial work environment, were analyzed using thematic analysis. RESULTS: High staff turnover and a preponderance of inexperienced nurses were described as stressful and detrimental to group cohesion. Work at the unit was considered overly demanding for newly qualified nurses, while senior nurses expressed frustration at the work of training new nurses who might not stay. While some were very satisfied with the group climate, others complained of a negative climate and incivilities from some experienced nurses toward new recruits. CONCLUSIONS: High turnover and variable competence among staff present challenges for maintaining a positive organizational climate. IMPLICATIONS FOR NURSING MANAGEMENT: Management should communicate a clear sense of the nature of neonatal intensive care when recruiting, foster group cohesion (e.g., by creating stable work teams) and reward commitment to working at the unit.

Prevalencia de infección por SARS-CoV-2 durante la primera oleada de la pandemia entre personal sanitario y no sanitario del Hospital General de Segovia, Castilla y León / Prevalence of SARS-CoV-2 infection during the first wave of the pandemic among health and non-health personnel of the General Hospital of Segovia, Castilla y León

Introducción. Los trabajadores sanitarios y no sanitarios(TSyNS) de un hospital están más expuestos al contagio porSARS-CoV-2 que la población general. Estudiamos la prevalencia de esta infección en los trabajadores del hospital de Segovia tras la primera ola.Material y métodos. Estudio monocéntrico, observacional, transversal, realizado entre el 29 de abril y el 14 de mayode 2020. Se diagnosticó la infección mediante test de inmunocromatografía capilar para anticuerpos IgG y/o IgM, o PCR. Seestudiaron variables laborales, de salud, y de exposición.Resultados. Participaron en el estudio 1.335 TSyNS de untotal 1.667 (80,1%), un 79,3% mujeres, con una edad media de47,3 años, y de 47,1 para los hombres. La prevalencia de infectados fue del 21,95%, el 24,7% asintomáticos. La edad presentó una OR significativa de 1,02/año. La exposición extralaboralaumentó la prevalencia un 16,8%. El uso continuado del Equipo de Protección Individual (EPI) y la administración de nebulizaciones presentaron una OR de 0,54 y 0,46 respectivamente.Los síntomas asociados a mayor prevalencia fueron anosmia(OR 9,31), ageusia (OR 3,05), y fiebre (OR 1,94). Hasta la fecha,el 75% de los TSyTNS infectados lo hicieron en la primera ola.Conclusiones. La prevalencia es mayor entre los TSyNSque en la población general. La edad se asocia a una mayorprevalencia de infección. Casi un 25% de los infectados fueasintomático. El uso de EPI de forma continuada se asoció amenor prevalencia. Los síntomas con mayor asociación fueronfiebre, anosmia, y ageusia. (AU)

Introduction. Health and non-health workers (H&NH-W)in a hospital are more exposed to SARS-CoV-2 infection thanthe general population. We studied the prevalence of this infection in these workers of Segovia´s Hospital after the firstepidemic wave.Material and methods. Monocentric, observational,cross-sectional study, carried out between April 29 and May14, 2020. The infection was diagnosed by capillary immunochromatography test for IgG and / or IgM antibodies, or PCR.Work, health, and exposure variables were studied.Results. A total of 1,335 H&NH-W participated in thestudy out of a total of 1,667 (80.1%), 79.3% women, with amean age of 47.3 years, and 47.1 for men. The prevalence ofinfected was 21.95%, 24.7% asymptomatic. Age presented asignificant OR of 1.02/year. Exposure outside of work increasedthe prevalence by 16.8%. The continued use of Personal Protective Equipment (PPE) and the administration of nebulizations presented an OR of 0.54 and 0.46 respectively. The symptoms associated with the highest prevalence were anosmia(OR 9.31), ageusia (OR 3.05), and fever (OR 1.94). Today, about75% of H&NH-W were infected in the first wave.Conclusions. The prevalence is higher among healthcareworkers than the population they serve. Age is associated witha higher prevalence of infection. Almost a quarter of thoseinfected were asymptomatic. The continuous use of PPE wasassociated with a lower prevalence, for that the administrationof nebulisations could be safe. The symptoms with the greatestassociation were fever, anosmia, and ageusia (AU)

[Prevalence of SARS-CoV-2 infection during the first wave of the pandemic among health and non-health personnel of the General Hospital of Segovia, Castilla y León]. / Prevalencia de infección por SARS-CoV-2 durante la primera oleada de la pandemia entre personal sanitario y no sanitario del Hospital General de Segovia, Castilla y León.

OBJECTIVE: Health and non-health workers (HNH-W) in a hospital are more exposed to SARS-CoV-2 infection than the general population. We studied the prevalence of this infection in these workers of Segovia´s Hospital after the first epidemic wave. METHODS: Monocentric, observational, cross-sectional study, carried out between April 29 and May 14, 2020. The infection was diagnosed by capillary immunochromatography test for IgG and / or IgM antibodies, or PCR. Work, health, and exposure variables were studied. RESULTS: A total of 1,335 HNH-W participated in the study out of a total of 1,667 (80.1%), 79.3% women, with a mean age of 47.3 years, and 47.1 for men. The prevalence of infected was 21.95%, 24.7% asymptomatic. Age presented a significant OR of 1.02/year. Exposure outside of work increased the prevalence by 16.8%. The continued use of Personal Protective Equipment (PPE) and the administration of nebulizations presented an OR of 0.54 and 0.46 respectively. The symptoms associated with the highest prevalence were anosmia (OR 9.31), ageusia (OR 3.05), and fever (OR 1.94). Today, about 75% of HNH-W were infected in the first wave. CONCLUSIONS: The prevalence is higher among healthcare workers than the population they serve. Age is associated with a higher prevalence of infection. Almost a quarter of those infected were asymptomatic. The continuous use of PPE was associated with a lower prevalence, for that the administration of nebulisations could be safe. The symptoms with the greatest association were fever, anosmia, and ageusia.

[Low incidence of SARS-CoV-2 infections in healthcare workers at a tertiary care hospital : Results of a prospective serological cohort study of the first and second COVID­19 pandemic wave]. / Niedrige Inzidenz von SARS-CoV­2-Infektionen bei Krankenhausmitarbeitern eines Maximalversorgers : Ergebnisse einer prospektiven serologischen Kohortenstudie der ersten und zweiten COVID­19-Welle.

BACKGROUND: Healthcare workers caring for coronavirus disease 2019 (COVID­19) patients are at an increased risk for a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The aim of this seroepidemiological study was to evaluate the risk of infection for employees at a tertiary care hospital. METHODS: Serological tests for antibodies against SARS-CoV­2 were carried out in a prospective cohort of employees directly involved in the care of COVID­19 patients every 2 weeks from March to July 2020 (1st wave). Antibody status was examined again between December 2020 and February 2021 (2nd wave). RESULTS: The seroprevalence of antibodies against SARS-CoV­2 was 5.1% at the end of the study in February 2021. The cumulative incidence was 3.9% after a median observation period of 261 days. CONCLUSION: We observed a low risk of SARS-CoV­2 infection comparable to that of the general population in the examined cohort of healthcare workers involved in the acute care of COVID­19 patients under the applied hygiene and protective measures.