Characteristics Of Healthcare Workers Research Articles

Characteristics of health care workers with SARS-CoV-2 at a COVID-19 hospital in Türkiye: Homologous versus heterologous vaccination.

Given the limited studies on types of vaccination and infection rates among health care workers (HCWs) in Türkiye, we analyzed the demographic, clinical, and vaccination characteristics as well as the attitudes of HCWs who have been infected with COVID-19. We retrospectively analyzed demographic and clinical data on breakthrough COVID-19 infections in HCWs from hospital surveillance data collected between April 5, 2020, and November 1, 2022. The comparison was based on four subgroups that consisted of unvaccinated, one-shot-vaccinated, homologous vaccinated, and heterologous vaccinated individuals. Participants who received various combinations of Sinovac/CoronaVac and/or BioNTech/Pfizer vaccines were compared for detection of COVID-19. During a 33-month period of 744 HCWs who contracted COVID-19, women (65.3%) and nurses (28.9%) were the most affected, followed by doctors (25.8%). Of the infected HCWs, only 1.3% required hospitalization, 0.3% required ICU support, and 98.4% were outpatients. By vaccination status, 143 of the HCWs (19.2%) were unvaccinated, 292 (39.2%) were homologously vaccinated, 294 (39.5%) were heterologously vaccinated, 15 (2%) received a single shot, 206 (27.7%) received two shots, and 165 (22.2%) received three shots. All HCWs contracted COVID-19 at a mean of 134-days (range:1-539) after vaccination. While the proportions of homologously and heterologously vaccinated HCWs were similar, the time elapsed from vaccination to contracting COVID-19 varied (mean 143.4±106.7 vs.126.4±82.43 days). Among both outpatients and inpatients with COVID-19, women HCWs outnumbered men HCWs. HCWs who received homologous vaccination contracted COVID-19 later than those who received heterologous vaccination.

Willingness and self-confidence of healthcare workers in Bahrain in assisting with in-flight emergencies.

In-flight medical emergency (IFE) impose considerable challenges on healthcare workers (HCWs) because of limited resources, constrained environment, and medico-legal issues. This study assessed HCWs knowledge, willingness, and confidence in addressing in-flight medical emergencies. A cross-sectional study was conducted between June and August 2023 among nurses and physicians working in primary healthcare centers and governmental hospitals in Bahrain. Subjects were selected using stratified random sampling; a self-administered online questionnaire of high reliability (Cronbach alpha = 0.914) was used to collect the data. Logistic regression analysis were performed to determine association of knowledge, willingness, and confidence in dealing with in-flight emergencies with various characteristics of HCWs. The study included 805 HCWs with mean age of 35.5 years (SD=9.2). The findings indicated deficiency in training, with <10% of participants trained on IFE. A considerable proportion of participants exhibited low levels of knowledge (88.3%) and confidence (75.9%) with IFE. Nonetheless, more than half of the participants expressed the willingness to assist in IFE (59.1%). Non-Bahraini healthcare professionals (odds ratio [OR] = 2.901, P < 0.001) had higher knowledge of IFE. Nurses (OR = 1.642, P = 0.047) and participants with longer work experience had higher willingness to assist in IFE. In addition, professionals who were non-Bahraini (OR = 3.249, P < 0.001), working in secondary care (OR = 1.619, 95% confidence interval P = 0.021), had had training on IFE (OR = 2.247, P = 0.004), and had encountered IFE before (OR = 1.974, P = 0.006) had greater self-confidence levels. Considering the low levels of knowledge and confidence healthcare professionals in Bahrain had with regard to IFE, targeted training initiatives and educational programs are necessary to improve HCW's confidence and preparedness to deal with such emergencies.

Health Care Workers' Motivations for Enrolling in Massive Open Online Courses During a Public Health Emergency: Descriptive Analysis.

Massive open online courses (MOOCs) are increasingly used to educate health care workers during public health emergencies. In early 2020, the World Health Organization (WHO) developed a series of MOOCs for COVID-19, introducing the disease and strategies to control its outbreak, with 6 courses specifically targeting health care workers as learners. In 2020, Stanford University also launched a MOOC designed to deliver accurate and timely education on COVID-19, equipping health care workers across the globe to provide health care safely and effectively to patients with the novel infectious disease. Although the use of MOOCs for just-in-time training has expanded during the pandemic, evidence is limited regarding the factors motivating health care workers to enroll in and complete courses, particularly in low-income countries (LICs) and lower-middle-income countries (LMICs). This study seeks to gain insights on the characteristics and motivations of learners turning to MOOCs for just-in-time training, to provide evidence that can better inform MOOC design to meet the needs of health care workers. We examine data from learners in 1 Stanford University and 6 WHO COVID-19 courses to identify (1) the characteristics of health care workers completing the courses and (2) the factors motivating them to enroll. We analyze (1) course registration data of the 49,098 health care workers who completed the 7 focal courses and (2) survey responses from 6272 course completers. The survey asked respondents to rank their motivations for enrollment and share feedback about their learning experience. We use descriptive statistics to compare responses by health care profession and by World Bank country income classification. Health care workers completed the focal courses from all regions of the world, with nearly one-third (14,159/49,098, 28.84%) practicing in LICs and LMICs. Survey data revealed a diverse range of professional roles among the learners, including physicians (2171/6272, 34.61%); nurses (1599/6272, 25.49%); and other health care professionals such as allied health professionals, community health workers, paramedics, and pharmacists (2502/6272, 39.89%). Across all health care professions, the primary motivation to enroll was for personal learning to improve clinical practice. Continuing education credit was also an important motivator, particularly for nonphysicians and learners in LICs and LMICs. Course cost (3423/6272, 54.58%) and certification (4238/6272, 67.57%) were also important to a majority of learners. Our results demonstrate that a diverse range of health care professionals accessed MOOCs for just-in-time training during a public health emergency. Although all health care workers were motivated to improve their clinical practice, different factors were influential across professions and locations. These factors should be considered in MOOC design to meet the needs of health care workers, particularly those in lower-resource settings where alternative avenues for training may be limited.

Examining the feasibility of assisted index case testing for HIV case-finding: a qualitative analysis of barriers and facilitators to implementation in Malawi

BackgroundAssisted index case testing (ICT), in which health care workers take an active role in referring at-risk contacts of people living with HIV for HIV testing services, has been widely recognized as an evidence-based intervention with high potential to increase status awareness in people living with HIV. While the available evidence from eastern and southern Africa suggests that assisted ICT can be an effective, efficient, cost-effective, acceptable, and low-risk strategy to implement in the region, it reveals that feasibility barriers to implementation exist. This study aims to inform the design of implementation strategies to mitigate these feasibility barriers by examining “assisting” health care workers’ experiences of how barriers manifest throughout the assisted ICT process, as well as their perceptions of potential opportunities to facilitate feasibility.MethodsIn-depth interviews were conducted with 26 lay health care workers delivering assisted ICT in Malawian health facilities. Interviews explored health care workers’ experiences counseling index clients and tracing these clients’ contacts, aiming to inform development of a blended learning implementation package. Transcripts were inductively analyzed using Dedoose coding software to identify and describe key factors influencing feasibility of assisted ICT. Analysis included multiple rounds of coding and iteration with the data collection team.ResultsParticipants reported a variety of barriers to feasibility of assisted index case testing implementation, including sensitivities around discussing ICT with clients, privacy concerns, limited time for assisted index case testing amid high workloads, poor quality contact information, and logistical obstacles to tracing. Participants also reported several health care worker characteristics that facilitate feasibility (knowledge, interpersonal skills, non-stigmatizing attitudes and behaviors, and a sense of purpose), as well as identified process improvements with the potential to mitigate barriers.ConclusionsMaximizing assisted ICT’s potential to increase status awareness in people living with HIV requires equipping health care workers with effective training and support to address and overcome the many feasibility barriers that they face in implementation. Findings demonstrate the need for, as well as inform the development of, implementation strategies to mitigate barriers and promote facilitators to feasibility of assisted ICT.Trial registrationNCT05343390. Date of registration: April 25, 2022.

A test-based strategy for early return to work for health-care workers with COVID-19 during the Omicron wave, Brunei Darussalam, 2022.

This paper summarizes and evaluates a test-based strategy for early return to work for health-care workers (HCWs) with mild coronavirus disease in Brunei Darussalam during the Omicron wave in February 2022 and compares the characteristics of HCWs by how long it took them to return to work. The early return-to-work strategy involved testing on day 3 of infection with reverse transcription-polymerase chain reaction and with a rapid antigen test on days 5 and 6 or days 5 and 7. Data about infected HCWs were extracted from the Ministry of Health's public health surveillance database. Percentages and proportions were used for descriptive statistics, and Pearson's χ2 test and the paired t-test were used to compare return-to-work patterns with demographic factors and vaccination status of the HCWs, as well as between cycle threshold (Ct) values and occupational groups of HCWs. From 15 February to 15 March 2022, a total of 1121 HCWs were notified as being infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Of these, 175 (15.6%) were able to return to work on day 4 of their infection, 153 (13.6%) on day 6 and 268 (23.9%) on day 7; 525 (46.8%) required 10 days of home isolation. Statistically significant associations were observed between return-to-work periods and occupational group (P<0.01) and Ct value (P<0.01), but not between return to work and age, sex or vaccination status. This test-based strategy ensured a balance between mitigating a shortage of HCWs and enabling them to return to work early without compromising their safety and that of their patients.

Knowledge and Practice of Infection Prevention and Control among Healthcare Workers in Secondary Healthcare Facilities in Southern Cross River State Nigeria

Abstract Background: Globally, millions of people are affected annually by health-care-associated infections, many of which could be avoided by strict compliance with standard infection prevention and control (IPC) protocols. Aim: This study assessed the knowledge and practice of IPC among secondary health-care workers (HCWs) in Southern Cross River State. Materials and methods: A structured questionnaire was used in conjunction with a descriptive cross-sectional design to collect data from 336 health-care personnel. IBM SPSS Statistics version 25 was used to analyse the generated data. Results: The results show that 58% of the respondents had a high knowledge level of IPC and 52.4% exhibited a high level of standard IPC practice. About 53% reported that IPC protocols were available in their facility. No association was found between sociodemographic characteristics of HCWs and their practice of standard IPC practice except for sex. A significant association was found between sex and level of IPC practice (P = 0.015), the male HCWs had higher practice of IPC than their female counterparts. Although no association was found between knowledge and practice of IPC among the HCWs, the level of practice was, however, higher among the doctors than the nurses who had a higher level of knowledge on IPC. A logistic regression analysis further showed that only sex was significant (P = 0.021) in influencing a high level of IPC practice among the HCWs in this study. Conclusion: It is, therefore, imperative for health-care facility leadership to organise training and retraining programs on IPC to improve knowledge and compliance among HCWs, especially in the face of emerging infectious diseases in Nigeria.

COVID-19 vaccine breakthrough infections among health care workers of a tertiary care center in North Kerala: a descriptive study

Background: Vaccination against COVID-19 was started in India in January 2021 using ChAdOx1 nCoV-19 vaccine and health care workers were the first category to get vaccinated. The objective of the present study was to compare the characteristics of health care workers who had COVID-19 vaccine breakthrough infection with those who did not have breakthrough infection. Methods: This was a descriptive study conducted among 110 health care workers in a tertiary care center in North Kerala during 1, June 2021 to 31, July 2021. An equal number of health care workers who developed breakthrough COVID infection (55) and those who did not develop breakthrough infection (55) were included in the study. Results: The mean age of individuals who had breakthrough infection was 33.18 years (±9.52) and those of individuals who did not develop disease was 31.2years (±9.57). It was also observed that 21.8% of those with breakthrough infection and 10.9% of individuals without breakthrough infection had comorbidities. The study also found that individuals who took second dose of vaccine at an interval of 28-35 days from the first dose had higher chance of developing breakthrough infection compared to those who took second dose more than 35 days after first dose. Conclusions: The present study found that breakthrough infection was more common among those who took second dose of vaccine at an interval less than 35 days from the first dose. It was observed that numbers of individuals with comorbidities were higher among breakthrough infection group, but further studies are needed for better understanding.

The prevalence and risk factors for tuberculosis among healthcare workers in Yogyakarta, Indonesia.

Healthcare workers (HCWs) are at risk of contracting TB, particularly when in high tuberculosis (TB) burden settings. Routine surveillance data and evidence are limited on the burden of TB amongst HCWs in Indonesia. We aimed to measure the prevalence of TB infection (TBI) and disease among HCWs in four healthcare facilities in Yogyakarta province in Indonesia, and explore risk factors for TBI. A cross-sectional TB screening study targeted all HCWs from four pre-selected facilities (1 hospital, 3 primary care) in Yogyakarta, Indonesia. Voluntary screening included symptom assessment, Chest X-ray (CXR), Xpert MTB/RIF (if indicated) and tuberculin skin test (TST). Analyses were descriptive and included multivariable logistic regression. Of 792 HCWs, 681 consented (86%) to the screening; 59% (n = 401) were female, 62% were medical staff (n = 421), 77% worked in the one participating hospital (n = 524), and the median time working in the health sector was 13 years (IQR: 6-25 years). Nearly half had provided services for people with TB (46%, n = 316) and 9% reported ever having TB (n = 60). Among participants with presumptive TB (15%, n = 99/662), none were diagnosed microbiologically or clinically with active TB disease. TBI was detected in 25% (95% CI: 22-30; n = 112/441) of eligible HCWs with a TST result. A significant association was found between TB infection and being male (adjusted Odds Ratio (aOR) 2.02 (95%CI: 1.29-3.17)), currently working in the participating hospital compared to primary care (aOR 3.15 (95%CI: 1.75-5.66)), and older age (1.05 OR increase per year of life between 19-73 years (95%CI: 1.02-1.06)). This study supports prioritisation of HCWs as a high-risk group for TB infection and disease, and the need for comprehensive prevention and control programs in Indonesia. Further, it identifies characteristics of HCWs in Yogyakarta at higher risk of TBI, who could be prioritised in screening programs if universal coverage of prevention and control measures cannot be achieved.

Symptom characteristics of health care workers seeking outpatient psychiatric care during the COVID-19 pandemic.

Though there is a growing body of research establishing a broad negative psychological impact of COVID-19 among healthcare workers (HCWs), there are comparably fewer studies evaluating symptom presentation and clinical diagnoses among treatment-seeking HCWs. The present report seeks to fill this gap in the literature by establishing the prevalence of anxiety, depression, post-traumatic stress, alcohol misuse, and well-being among treatment-seeking HCWs. Data were collected from 421 treatment-seeking HCWs in an outpatient hospital-based mental health setting. Both self-report measures and semi-structured interviews were utilized to assess symptom severity and render psychiatric diagnosis at intake. Adjustment disorders were the most prevalent diagnosis at 44.2%. Of the 347 who completed self-report measures, over 47% endorsed moderate-to-severe depressive symptoms, with 13% endorsing suicidal ideation (SI). Fifty-eight percent scored in the moderate-to-severe range for anxiety, and 19% screened positive for COVID-related post-traumatic stress disorder. Further analyses revealed that those in medical support roles endorsed significantly greater depression symptoms relative to other groups and also reported SI at greater frequency. Medical trainees also endorsed SI at higher frequencies. These findings are consistent with previous research on the adverse impact of COVID-19 stressors on HCWs' mental health. We further identified vulnerable groups that are underrepresented in the literature. These findings highlight the need for targeted outreach and intervention among overlooked HCWs populations.

Factors associated with receipt of COVID-19 vaccination and SARS-CoV-2 seropositivity among healthcare workers in Albania (February 2021-June 2022): secondary analysis of a prospective cohort study.

Healthcare workers (HCWs) have been disproportionally affected by COVID-19. We investigated factors associated with two- and three-dose COVID-19 vaccine uptake and SARS-CoV-2 seropositivity among 1504 HCWs enrolled (19 February-7 May 2021) in a prospective COVID-19 vaccine effectiveness cohort in Albania through a secondary analysis. We collected sociodemographic, occupational, health, prior SARS-CoV-2 infection, and COVID-19 vaccination data from all HCWs at enrollment. Vaccination status was assessed weekly through June 2022. A serum sample was collected from all participants at enrollment and tested for anti-spike SARS-CoV-2 antibodies. We analyzed HCWs characteristics and outcomes using multivariable logistic regression. By 11 June 2022, 1337 (88.9%) HCWs had received two COVID-19 vaccine doses, of whom 255 (19.1%) received a booster. Factors significantly associated with receiving three doses (adjusted odds ratio (aOR), 95% CIs) were being ≥35 years (35-44 years: 1.76 (1.05-2.97); 45-54 years: 3.11 (1.92-5.05); ≥55 years: 3.38 (2.04-5.59)) and vaccinated against influenza (1.78; 1.20-2.64). Booster dose receipt was lower among females (0.58; 0.41-0.81), previously infected (0.67; 0.48-0.93), nurses and midwives (0.31; 0.22-0.45), and support staff (0.19; 0.11-0.32). Overall 1076 (72%) were SARS-CoV-2 seropositive at enrollment. Nurses and midwifes (1.45; 1.05-2.02), support staff (1.57; 1.03-2.41), and HCWs performing aerosol-generating procedures (AGPs) (1.40; 1.01-1.94) had higher odds of being seropositive, while smokers had reduced odds (0.55; 0.40-0.75). In a large cohort of Albanian HCWs, COVID-19 vaccine booster dose uptake was very low, particularly among younger, female, and non-physician HCWs, despite evidence demonstrating the added benefit of boosters in preventing infection and severe disease. Reasons behind these disparities should be explored to develop targeted strategies in order to promote uptake in this critical population. SARS-CoV-2 seroprevalence was higher among non-physicians and HCWs performing APGs. A better understanding of the factors contributing to these differences is needed to inform interventions that could reduce infections in the future. This study was funded by the Task Force for Global Health (US Centers for Disease Control (CDC) cooperative agreement # NU51IP000873) and the World Health Organization, Regional Office for Europe.

Psychological impact of the covid 19 pandemic on health care workers

IntroductionThe COVID 19 pandemic had a significant psychological impact worldwide. Health care workers (HCWs) were the most affected because of the pandemic burden and occupational exigencies.ObjectivesTo describe epidemiological characteristics of HCWs with post COVID19 anxiodepressive disorders.MethodsA descriptive cross-sectional study was carried out. It included HCWs of a university hospital who consulted the Occupational Medicine Clinics for the three-month post-COVID‘s medical visit. The study was carried out during the period March 2020 to January 2022. The data was collected using a questionnaire including socio-occupational and medical characteristics. Psychometric evaluation was carried out using « the Hospital Anxiety and Depression Scale »ResultsWe have collected 164 HCWs. The sex ratio (M/F) was 0.29. The average age was 41±9.8 years. They belonged to the pneumology (27%), intensive care (11%) and biology laboratory (11%). The prevalence of anxiety and depression was 34% and 30% respectively. We found an association between sleep disorders and anxiety (p=0.000), OR=5 IC95%[2.4-10.3] and depression (p=0.000), OR= 4 IC 95%[2.0-9.3]. We found an association between anxiety and persistent fatigue (p=0,000), OR=4[2,0-8,6], anxiety and concentration and memory difficulties (p=0,000), OR=3 IC 95%[1,7-6,9]. Referral to psychiatric consultations were done in 16% of the cases.ConclusionsPost-COVID anxiety disorders were frequent among HCWs and associated with neurocognitive disorders. Psychiatric support and early treatment are necessary to prevent mental deterioration.Disclosure of InterestNone Declared

Deepening Our Understanding of COVID-19 Vaccine Decision-Making amongst Healthcare Workers in Southwest Virginia, USA Using Exploratory and Confirmatory Factor Analysis

Vaccine hesitancy amongst healthcare workers (HCWs) has been a major challenge throughout the COVID-19 pandemic. While many studies have identified HCW characteristics and specific attitudes associated with COVID-19 vaccine hesitancy, researchers are still working towards developing a holistic understanding of the psychological constructs that influence COVID-19 vaccine decision-making in this population. Between 15 March and 29 March 2021, we distributed an online survey assessing individual characteristics and vaccine-related perceptions to employees of a not-for-profit healthcare system in Southwest Virginia (N = 2459). We then performed exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) to describe patterns of vaccine-related thought amongst HCWs and identify latent psychometric constructs involved in vaccine decision-making. The goodness of model fit was assessed using the Tucker-Lewis Index (TLI), the Comparative Fit Index (CFI), and the Root Mean Square Error of Approximation (RMSEA). Internal consistency and reliability of each factor were assessed using Cronbach's alpha. EFA identified four latent psychometric constructs: Lack of trust in the COVID-19 vaccine; Anti-science sentiment; Adverse side-effects; and Situational risk assessment. The goodness of EFA model fit was adequate (TLI > 0.90, RMSEA ≤ 0.08) with acceptable internal consistency and reliability for three of four factors (Cronbach's alpha > 0.70). The CFA model also had adequate goodness of fit (CFI > 0.90, RMSEA ≤ 0.08). We believe the psychometric constructs identified in this study can provide a useful framework for interventions to improve vaccine uptake amongst this critical population.

The language of healthcare worker emotional exhaustion: A linguistic analysis of longitudinal survey.

Emotional exhaustion (EE) rates in healthcare workers (HCWs) have reached alarming levels and been linked to worse quality of care. Prior research has shown linguistic characteristics of writing samples can predict mental health disorders. Understanding whether linguistic characteristics are associated with EE could help identify and predict EE. To examine whether linguistic characteristics of HCW writing associate with prior, current, and future EE. A large hospital system in the Mid-West had 11,336 HCWs complete annual quality improvement surveys in 2019, and 10,564 HCWs in 2020. Surveys included a measure of EE, an open-ended comment box, and an anonymous identifier enabling HCW responses to be linked across years. Linguistic Inquiry and Word Count (LIWC) software assessed the frequency of one exploratory and eight a priori hypothesized linguistic categories in written comments. Analysis of covariance (ANCOVA) assessed associations between these categories and past, present, and future HCW EE adjusting for the word count of comments. Comments with <20 words were excluded. The frequency of the linguistic categories (word count, first person singular, first person plural, present focus, past focus, positive emotion, negative emotion, social, power) in HCW comments were examined across EE quartiles. For the 2019 and 2020 surveys, respondents wrote 3,529 and 3,246 comments, respectively, of which 2,101 and 1,418 comments (103,474 and 85,335 words) contained ≥20 words. Comments using more negative emotion (p < 0.001), power (i.e., references relevant to status, dominance, and social hierarchies, e.g., own, order, and allow) words (p < 0.0001), and words overall (p < 0.001) were associated with higher current and future EE. Using positive emotion words (p < 0.001) was associated with lower EE in 2019 (but not 2020). Contrary to hypotheses, using more first person singular (p < 0.001) predicted lower current and future EE. Past and present focus, first person plural, and social words did not predict EE. Current EE did not predict future language use. Five linguistic categories predicted current and subsequent HCW EE. Notably, EE did not predict future language. These linguistic markers suggest a language of EE, offering insights into EE's etiology, consequences, measurement, and intervention. Future use of these findings could include the ability to identify and support individuals and units at high risk of EE based on their linguistic characteristics.

A Multi-center Retrospective Analysis of Healthcare Workers after COVID-19: Epidemiological and Clinical Features

Objective: Concerns regarding the high-level risk of infection among healthcare workers (HCWs) increased after COVID19 was declared as a pandemic in March 2020. Inadequate infection control owing to a shortage of personal protective equipment or an inconvenient usage of infection control measures may play a significant role in transmission to/among healthcare personnel. The study aimed to determine the characteristics and outcomes of COVID-19 patients who are healthcare workers along with possible transmission routes of COVID-19 in four different healthcare facilities in Istanbul. &#x0D; Methods: All hospital records were reviewed retrospectively. Demographic and clinical characteristics of HCWs were documented, and all infected HCWs were subjected to a phone-based mini-questionnaire and three-dimensional test (TDT). All statistical analyses were done using statistical packages SPSS Demo Ver 22 (SPSS Inc. Chicago, IL, USA). &#x0D; Results: Clinical features of COVID-19 were similar to the general public’s characteristics. The most frequent symptoms were cough, fever, and headache. HCWs with the O blood group tend to have asymptomatic COVID-19 infection. Hospital workers other than medical professionals have a lack of convenience of infection control measures. The median duration of PCR negativity was 9 days. HCWs who had a sore throat at the beginning of COVID-19 have a longer PCR-positive duration. &#x0D; Conclusion: Understanding the clinical features or characteristics of asymptomatic COVID-19 carriers may aid in the implementation of a feasible screening program for early detection. It is strongly advised that proper infection control precautions, education, and auditing of nonclinical staff be implemented. As a result, transmission among healthcare workers can be avoided.

SARS-CoV-2 infections and attitudes towards COVID-19 vaccines among healthcare workers in the New York Metropolitan area, USA

ObjectiveBecause of their increased interaction with patients, healthcare workers (HCWs) face greater vulnerability to COVID-19 exposure than the general population. We examined prevalence and correlates of ever COVID-19 diagnosis and...

Knowledge, attitudes and practices on childhood TB among healthcare workers.

SUMMARYBACKGROUND :Increasing childhood TB case detection requires the deployment of diagnostic services at peripheral healthcare level. Capacity and readiness of healthcare workers (HCWs) are key to the delivery of innovative approaches.METHODS :In 2019, HCWs from five district hospitals (DHs) and 20 primary healthcare centres (PHCs) in Cambodia, Cameroon, Cote d’Ivoire, Sierra Leone and Uganda completed a self-administered knowledge-attitudes-practices (KAP) questionnaire on childhood TB. We computed knowledge and attitudes as scores and identified HCW characteristics associated with knowledge scores using linear regression.RESULT:Of 636 eligible HCWs, 497 (78%) participated. Median knowledge scores per country ranged between 7.4 and 12.1 (/18). Median attitude scores ranged between 2.8 and 3.3 (/4). Between 13.3% and 34.4% of HCWs reported diagnosing childhood with (presumptive) TB few times a week. Practising at PHC level, being female, being involved in indirect TB care, having a non-permanent position, having no previous research experience and working in Cambodia, Cameroon, Cote d’Ivoire and Sierra Leone as compared to Uganda were associated with a lower knowledge score.CONCLUSION :HCWs had overall limited knowledge, favourable attitudes and little practice of childhood TB diagnosis. Increasing HCW awareness, capacity and skills, and improving access to effective diagnosis are urgently needed.

Healthcare Workforce Response to The Coronavirus Disease Outbreak in Daegu, Korea: A Multi-Center, Cross-Sectional Survey.

BackgroundSecuring an available healthcare workforce is critical to respond to coronavirus disease 2019 (COVID-19); however, research investigating Korea’s COVID-19 staffing response is rare. To present the fundamental data of healthcare staff in response to the surge in COVID-19 cases, we investigated the healthcare workforce response in Daegu, South Korea, which experienced the first largest outbreak of COVID-19 outside of China.Materials and MethodsIn response to the COVID-19 outbreak, this retrospective cross-sectional study analyzed data on the scale and characteristics of healthcare workers (HCWs). Additionally, it analyzed the clinical and epidemiological characteristics of HCWs infected with COVID-19 in six major teaching hospitals (five tertiary and one secondary) in Daegu from January 19 to April 30, 2020.ResultsDuring this study period, only 1.3% (n = 611) of the total hospitalized patients (n = 48,807) were COVID-19 inpatients, but they occupied 6.0% (n = 303) of the total hospital beds (n = 5,056), and 23.7% (n = 3,471) of all HCWs (n = 14,651) worked in response to COVID-19. HCWs participating in COVID-19-related works comprised 50.6% (n = 1,203) of doctors (n = 2,379), 26.3% (n = 1,571) of nurses (n = 5,982), and 11.4% (n = 697) of other HCWs (n = 6,108). Only 0.3% (n = 51) of HCWs (n = 14,651) developed COVID-19 infections from community-acquired (66.7%) or hospital-acquired (29.4%). Nurses were affected predominantly (33.3%), followed by doctors (9.8%), caregivers (7.8%), radiographers (5.9%), and others (45.1%), including nurse aides and administrative, facility maintenance, telephone appointment centers, and convenience store staff. All HCWs infected with COVID-19 recovered completely. The 32.7% (n = 333) of individuals (n = 1,018) exposed to HCWs who had COVID-19 were quarantined, and only one case of secondary transmission among them occurred.ConclusionThe COVID-19 pandemic has necessitated significant staffing and facility usage, which is disproportionate to the relatively low number of COVID-19 inpatients, imposing a substantial burden on healthcare resources. Therefore, beyond the current reimbursement level of the Korean National Health Insurance, a new type of rewarding system is needed to prepare hospitals for the emerging outbreaks of infectious diseases. Keeping HCWs safe from COVID-19 is crucial for maintaining the healthcare workforce during a sudden massive outbreak. Further studies are needed to determine the standards of required HCWs through detailed research on the working hours and intensity of HCWs responding to COVID-19.

Investigating the psychological impact of COVID-19 on healthcare workers in the intensive care unit

Background/Aim: The disease caused by the SARS-CoV-2 virus, COVID-19, has become the first viral disease outbreak defined as a pandemic in the 21st century. Experience with previous endemics shows that critical care workers disproportionately suffer from depression and anxiety after facing such outbreaks; however, data are limited regarding the early phase of spread. Our aim was to investigate depression and anxiety in healthcare workers employed in ICUs during the initial phase of COVID-19 spread in Istanbul, Turkey, and possible relationships with various characteristics of healthcare workers. Methods: This cross-sectional study evaluated descriptive and demographic characteristics, professions, COVID-19-related perceptions, depression and anxiety in healthcare workers from the 12 ICUs of six hospitals located in Istanbul, Turkey. The Beck Depression (Beck-D) and Anxiety (Beck-A) Inventories and the State-Trait Anxiety Inventory (STAI) TX-I and TX-II were used to assess depression and anxiety. Employees that worked in ICUs were included, regardless of profession, ICU type (neonatal/pediatric or adult), age, education and working status. We compared recorded data among employees with regard groups based on ICU type, sex, education status, profession, marital status, children, cohabiting status, and whether they were residing at their home. Additionally, multivariable regression analyses were performed to identify factors that were independently associated with scores obtained from the depression and anxiety scales. Results: A third of the studied population were found to have moderate-to-severe levels of depression and anxiety according to the Beck-D and Beck-A scales. The STAI TX-I scores were similar in all comparison groups except for significantly higher scores in participants living with their family/friends (P=0.027). STAI TX-II scores were higher in pediatric/neonatal ICU workers (P=0.001), nurses (P=0.002), employees without children (P=0.046), and those residing in their home (P=0.031). Beck-D scores were higher in nurses (P=0.001), those with lower education (P=0.025), subjects without children (P=0.008) and individuals living with their family/friends (P=0.002). Beck-A scores were higher in participants with lower education (P=0.001), nurses (P<0.001), those without children (P=0.049), subjects living with their family/friends (P=0.001), and those not residing in their home (P=0.003). There were only weak correlations between COVID-19-related perceptions and scale scores. Multivariable regression showed that being a physician and living alone were independently associated with lower Beck-D and Beck-A scores. Conclusion: The psychological impact of COVID-19 seems to be unassociated with disease-related perceptions during the early spread of disease, but about a third of ICU employees were found to have clinically-relevant levels of depression and anxiety. Our results show that nurses should receive continuous mental assessment and support, and that ICU employees may benefit from being provided with accommodation when caring for patients with diseases such as COVID-19.

P2/N95 filtering facepiece respirators: Results of a large-scale quantitative mask fit testing program in Australian health care workers

In response to the COVID-19 pandemic, 6,287 Australian health care workers (HCWs) were fit tested to N95 filtering facepiece respirators (FFRs). This study determined how readily HCWs were fitted to 8 FFRs and how age and sex influenced testing. HCWs were fit tested following the quantitative OSHA protocol. After bivariate analysis, a logistic regression model assessed the effect of FFR model, HCW age and sex on fit test results. Of 4,198 female and 2,089 male HCWs tested, 93.3% were successfully fitted. Fifty-five percent passed the first FFR, 21% required 2 and 23% required testing on 3 or more models. Males were 15% less likely to pass compared to females (P < .001). Individuals aged 18-29 were significantly more likely to pass compared to colleagues aged 30-59. Cup-style 3M 1860S was the most suitable model (95% CI: 1.94, 2.54) while the duckbill BSN TN01-11 was most likely to fail (95% CI: 0.11, 0.15). Current N95 FFRs exhibit suboptimal fit such that a large proportion (45%) of HCWs require testing on multiple models. Older age and male sex were associated with significantly higher fit failure rates. QNFT programs should consider HCW characteristics like sex, age, racial and facial anthropometric measurements to improve the protection of the health workforce.

800. Needle Stick And Sharps Injuries Among Health Care Workers – The Experience of a Tertiary Hospital in Jamaica

BackgroundDespite advances in occupational safety protocols in healthcare facilities, needle stick and sharps injuries (NSSIs) continue to be a concerning occurrence among healthcare workers (HCWs). Such exposures lead to the risk of blood borne infections as well as emotional and financial consequences which may be difficult to measure. Few studies on NSSIs among Jamaican HCWs have been published in the last decade. We evaluated adherence to established NSSIs management protocols and investigated the demographic and work-related characteristics of HCWs sustaining NSSIs. The proportion of HCWs affected and frequency and direct costs associated with these injuries were estimated.MethodsThis retrospective case-series reviewed HCWs employed or contracted to an urban tertiary teaching hospital in Jamaica, who reported NSSIs in the emergency room during the period January 1, 2015 and December 31, 2018. Archived incident reporting forms for these HCWs were reviewed. Data were analyzed using STATA 14 statistical software.Results57 cases of NSSIs were reported at an average rate of 1 per month and an annual incidence of 0.14 per 100 beds and 4.75 per 100 workers. 49 (86%) HCWs were female and 18 (14%) were male. 55% of HCWs were between the ages of 24-29 years old. Nurses (53%) and physicians (19%) made up most of the sample. 28 (58%) HCWs reported not wearing gloves during the incident. Improperly handling used sharps and re-capping needles were reported by 26 (46.5%) and 17 (30%) of HCWs respectively. HIV and viral Hepatitis screening of source patients were performed 85% and 55% of the time respectively. Only 25% of HCWs were prescribed HIV post exposure prophylaxis. Post-injury counselling occurred with 52 (91%) HCWs and follow up care arranged for 36% of cases. The mean direct cost associated with the initial management of the HCW was US &163.22 per NSSI.ConclusionThe frequency of reported NSSIs by HCWs is low but the burden of direct costs is high. There is inadequate adherence to NSSIs management protocols and accurate monitoring systems are lacking. We recommend the need for safer needle disposal methods and devices, routine auditing of sharps practices and training in occupational hazard prevention and management. This may improve occupational risk perception among HCWs and workplace safety. Disclosures All Authors: No reported disclosures