RESUMO
Passive transfer of antibodies from COVID-19 convalescent patients is being used as an experimental treatment for eligible patients with SARS-CoV-2 infections. The United States Food and Drug Administrations (FDA) guidelines for convalescent plasma recommends target antibody titers of 160. We evaluated SARS-CoV-2 neutralizing antibodies in sera from recovered COVID-19 patients using plaque reduction neutralization tests (PRNT) at low (PRNT50) and high (PRNT90) stringency thresholds. We found that neutralizing activity increased with time post symptom onset (PSO), reaching a peak at 31-35 days PSO. At this point, the number of sera having neutralizing titers of at least 160 was [~]93% (PRNT50) and [~]54% (PRNT90). Sera with high SARS-CoV-2 antibody levels (>960 ELISA titers) showed maximal activity, but not all high titer sera contained neutralizing antibody at FDA recommended levels, particularly at high stringency. These results underscore the value of serum characterization for neutralization activity.
RESUMO
Clinical nurse specialists (CNSs) are vital members of the healthcare delivery leadership team. The knowledge and expertise of the CNS is germane to the quality of care a patient receives. More than 50 CNSs practice at Massachusetts General Hospital (the state's first Magnet hospital), where they share their clinical skills, mentor staff through difficult situations, identify learning needs, and implement innovative approaches to patient care. This article presents a brief history of the CNS role and describes how the CNS role is operationalized at Massachusetts General Hospital and its impact on unit-based and organizational outcomes. In addition, several programs and interventions identified by the CNSs in response to results of the Staff Perception of the Professional Practice Environment Survey are discussed. How the CNS influences the professional development of staff and potential implications for the future role of the CNS are described. An exemplar is included depicting a typical work day of a CNS on an acute adult medical unit.
