Emergency Department Health Care Workers Research Articles

Violence against health-care workers in emergency departments: A study in Fez, Morocco

The issue of violence against health-care workers (HCWs) has garnered significant attention, necessitating urgent resolution due to escalating conflicts between HCWs and patients or their companions. Addressing this matter is paramount to mitigate its impact on HCWs and improve the quality of care afforded to citizens. To identify the underlying causes, particularly within emergency departments, we conducted a survey involving over 75 doctors and nurses across various hospitals to collect pertinent data. Our findings indicate that the health system is the major cause of violence, alongside the awareness of human rights fostered by social media. Furthermore, we conducted an interview with a doctor who has extensive experience working in emergency departments. Through this interview, he elucidated the extent to which this department poses dangers and the substandard conditions prevalent in the workplace. This study attempts to contribute scientifically toward finding efficient solutions, including legal measures, civil society initiatives, and police involvement. It suggests that reforms may be necessary in the functioning of these departments. This aspect represents an unsolved issue warranting further exploration.

What inhibits “speaking up” for patient safety among healthcare workers? A cross-sectional study in Malaysia

BackgroundIn healthcare, “speaking up” refers to when healthcare workers raise concerns regarding patient safety through questions, sharing information, or expressing their opinion to prevent harmful incidents and ensure patient safety. Conversely, withholding voice is an act of not raising concerns, which could be beneficial in certain situations. Factors associated with speaking up and withholding voices are not fully understood, especially in strong authoritarian societies, such as Malaysia. This study aimed to examine the factors associated with speaking up and withholding the voices of healthcare workers in Malaysia, thus providing suggestions that can be used in other countries facing similar patient safety challenges.MethodsThis cross-sectional study was conducted in a tertiary hospital in Sarawak State, Malaysia. Data were collected from 474 healthcare workers from 43 departments using a self-administered questionnaire for speaking up and withholding voices measures in 4 weeks prior to data analysis as well as socio-demographic factors of healthcare workers (sex, age group, profession, department, weekly work hours for patient care, years of employment in the hospital, and the hierarchical level) and speaking up related climate of the working environment were recorded. Data were analyzed using descriptive statistics. Logistic regression was performed to find out (adjusted) odds ratio of frequent speaking up and withholding voices.ResultsNurse compared to doctors and healthcare workers with short weekly working hours were more likely to speak up. Healthcare workers in emergency and intensive care department, those with short years of employment, and those who worked at low hierarchical levels were less likely to speak up. Healthcare workers in discouraging environment towards speaking up were more likely to withhold their voices.ConclusionsThis study demonstrates the characteristics of healthcare workers who speak up and those who withhold their voices in Malaysia. To ensure patient safety and prevent harm, it is essential to establish an encouraging environment that promotes speaking up and prevents withholding voices among healthcare worker, especially in circumstances where multiple types of healthcare workers with different socio-demographic backgrounds work together.

Emergency service health care workers’ opinions and experiences on the practice of family-witnessed resuscitation: a cross-sectional study during the COVID-19 pandemic in Türkiye

Despite the evidence and recommendations regarding the benefits of family-witnessed resuscitation, the opinions and attitudes of healthcare professionals vary widely. This descriptive cross-sectional study was conducted on 154 healthcare professionals working at the emergency departments of four hospitals within the borders of Ankara, Türkiye to examine their opinions and experiences on the practice of family-witnessed resuscitation. Data were collected by using the demographic form and the Family Presence Risk-Benefit Scale. Descriptive statistical analyses, t-test for samples, Mann-Whitney U test and Kruskal-Wallis tests were used in the evaluation of the data. Results indicated that majority of emergency department healthcare workers (85.8%) had no previous experience of family witnessed resuscitation, and most of them (96.8%) opposed the practice of resuscitation with family presence. Although nurses tended to favour family witnessed resuscitation more than physicians, most of the participants expressed their concerns about the presence of family during the CPR. It is recommended that institutional policies be developed on family-witnessed resuscitation, and inter-professional education be provided to increase the awareness of families and to change the opinions and attitudes of health care professionals.

Ethical Awareness and Practices Among Emergency Department Personnel in Riyadh's Tertiary Hospitals: A Cross-Sectional Analysis.

Ethical dilemmas in healthcare, particularly in emergency medical services (EMS), present significant challenges for healthcare workers (HCWs), necessitating a profound understanding of ethics and decision-making. This study assesses the ethical awareness and practices among HCWs in emergency departments of tertiary hospitals in Saudi Arabia, aiming to identify areas of strength and opportunities for improvement. A cross-sectional survey was conducted among 256 HCWs, including physicians, nurses, and administrative staff, in emergency departments across tertiary hospitals in Riyadh, Saudi Arabia. The questionnaire evaluated participants' knowledge of healthcare ethics, their experiences with ethical dilemmas, and the sources from which they derived their ethical understanding. The majority of participants exhibited a commendable level of ethical knowledge and practice, with frequent encounters of ethical or legal issues highlighting the pervasive nature of ethical challenges in emergency healthcare settings. Key sources of ethical knowledge included experiential learning and academic lectures, with a notable emphasis on practical experience. Despite the satisfactory level of ethical awareness, areas requiring further educational focus were identified, emphasizing the need for enhanced ethics training tailored to the emergency medical context. The findings underline the critical importance of incorporating ethics into the core of healthcare education and ongoing professional development for HCWs. Establishing a culture of continuous ethical dialogue and learning is essential for fostering patient-centered care and making informed ethical decisions in the fast-paced environment of emergency services. The study advocates for revising current ethics training programs to ensure they are comprehensive, relevant, and accessible, preparing HCWs to effectively address both current and future ethical challenges.

Emotional Freedom Techniques (EFT) Tapping for Pediatric Emergency Department Staff During the COVID-19 Pandemic: Evaluation of a Pilot Intervention.

Emergency-department (ED) staff may experience psychologic distress due to the stressful nature of their work. The COVID-19 pandemic exacerbated this distress. Emotional Freedom Techniques (EFT) tapping, a somatic psychophysiologic intervention combining vibratory acupressure with elements of cognitive-behavioral and exposure therapies, can reduce psychologic distress. This study tested the short-term effect of 10-minute EFT tapping on the psychologic distress of pediatric ED staff responding to COVID-19. During the COVID-19 pandemic, diverse staff in the pediatric ED of a New York City teaching hospital participated in this single-group study. A licensed creative arts therapist led participants in 10-minute EFT tapping sessions. A self-report questionnaire with 7 items based on the Trauma Exposure Response framework was administered immediately pre- and postintervention. Standardized mean differences between both timepoints were calculated. There were statistically significant reductions for 6 of the 7 items studied, including stress (3.32-2.14), obsessive and intrusive thoughts (2.50-1.85), feelings of pressure (3.20-2.17), loneliness (1.84-1.44), and emotional and physical pain (2.28-1.70); all P < 0.001. No significant changes in professional satisfaction were reported following the intervention. Despite the limitations of a single-arm study design, a 10-minute brief EFT tapping session was a promising way to reduce short-term psychologic distress in pediatric ED health care workers. Future studies, including rigorous randomized controlled trials, are needed to evaluate the effectiveness of brief EFT tapping interventions in other settings.

Healthcare provider perspectives on emergency department-initiated buprenorphine/naloxone: a qualitative study

BackgroundTake-home buprenorphine/naloxone is an effective method of initiating opioid agonist therapy in the Emergency Department (ED) that requires ED healthcare worker buy-in for large-scale implementation. We aimed to investigate healthcare workers perceptions of ED take-home buprenorphine/naloxone, as well as barriers and facilitators from an ED healthcare worker perspective.MethodsIn the context of a take-home buprenorphine/naloxone feasibility study at a tertiary care teaching hospital we conducted a descriptive qualitative study. We conducted one-on-one in person or telephone interviews and focus groups with ED healthcare workers who cared for patients given take-home buprenorphine/naloxone in the feasibility study at Vancouver General Hospital from July 2019 to March 2020. We conducted 37 healthcare worker interviews from December 2019 to July 2020. We audio recorded interviews and focus groups and transcribed them verbatim. We completed interviews until we reached thematic saturation.Data analysisWe inductively coded a sample of transcripts to generate a provisional coding structure and to identify emerging themes, which were reviewed by our multidisciplinary team. We then used the final coding structure to analyze the transcripts. We present our findings descriptively.ResultsParticipants identified a number of context-specific facilitators and barriers to take-home buprenorphine/naloxone provision in the ED. Participants highlighted ED conditions having either facilitative or prohibitive effects: provision of buprenorphine/naloxone was feasible when ED volume was low and space was available but became less so as ED volume increased and space decreased. Similarly, participants noted that patient-related factors could have a facilitative or prohibitive effect, such as willingness to wait (willing to stay in the ED for study-related activities and buprenorphine/naloxone initiation activities), receptiveness to buprenorphine/naloxone, and comprehension of the instructions. As for staff-related factors, time was identified as a consistent barrier. Time included time available and time required to initiate buprenorphine/naloxone (including time building rapport). Healthcare worker familiarity with buprenorphine/naloxone was noted as either a facilitating factor or a barrier, and healthcare workers indicated that ongoing training would have been advantageous. Many healthcare workers identified that the ED is an important first point of contact for the target patient population.ConclusionIntegrating a buprenorphine/naloxone program into ED care requires organizational supports (e.g., for managing buprenorphine/naloxone within limitations of ED volume, space, and time), and ongoing education of healthcare workers to minimize identified barriers.

Evaluation of COVID-19 antibody levels in emergency department healthcare workers

Evaluation of COVID-19 antibody levels in emergency department healthcare workers

Palliative care needs and barriers in an urban Ugandan Emergency Department: A mixed-methods survey of emergency healthcare workers and patients

BackgroundPalliative Care offers patient-centered, symptom-focused relief for patients with incurable disease, and early integration of palliative care ensures quality of life and death while reducing medical impoverishment. The Emergency Department is an ideal yet understudied, under-utilized location to initiate palliative care. ObjectiveTo evaluate the palliative care needs of patients with incurable disease and perceived barriers amongst healthcare providers in the Emergency Department of Kiruddu National Referral Hospital, Kampala, Uganda. MethodsA mixed methods survey of Emergency Department healthcare workers and patients was conducted. A crosse sectional survey of ninety-nine patients was conducted using the integrated Palliative Care Outcome Scale (IPOS). Eleven interviews were conducted with healthcare workers at Kiruddu Hospital, identified by purposive sampling. Descriptive and inferential statistics were used to analyze quantitative data.. Grounded theory approach was used to construct the in depth interview questions, code and analyze qualitative results and collapse these results into final themes. ResultsThe most common diagnoses were HIV/HIV-TB (32 %), heart disease (18 %), and sickle cell disease (14 %). The prevalence of unmet palliative care needs was substantial: more that 70 % of patients reported untreated symptoms e.g., pain, fatigue, difficulty breathing. Seventy-seven percent of the population reported severe or overwhelming pain. The main barriers to provision of palliative care in the Emergency Department as identified by healthcare workers were: (1) lack of adequate training in palliative care; (2) Challenges due to patient volume and understaffing; (3) the misconception that palliative care is associated with pain management alone; (4) Financial constraints as the greatest challenge faced by patients with incurable disease. ConclusionsWe report a high prevalence of unmet palliative care needs among patients in this urban Ugandan Emergency Department, and important barriers reported by emergency healthcare providers. Identification of these barriers offers opportunities to overcome them including harnessing novel mHealth interventions such as clinical support apps or telehealth palliative care consultants. Integration of palliative care in this setting would improve the care of vulnerable patients, provide healthcare workers with an additional care modality while likely adding value to the health system.

Sleep Disturbance and Burnout in Emergency Department Health Care Workers

This cross-sectional study examines the association of sleep disturbances with burnout among emergency medicine health care workers.

Comparing Job Satisfaction Among Healthcare Workers at Emergency Departments and Primary Healthcare Units During the COVID-19 Pandemic.

Background The primary healthcare professionals' work description changed during the COVID-19 pandemic, as was the case of all other healthcare departmental operation systems. Objectives This investigation compares job satisfaction betweenemergency department (ED) and primary healthcare professionals during the COVID-19 pandemic to ascertain the possible effect of the pandemic on healthcare providers. Methods A cross-sectional online self-assessment questionnaire consisting of 36 questions was distributed using available social media to targetall frontline healthcare workers (HCWs) in emergency departments and primary healthcare centres in Riyadh. The inclusive criterion was that the respondents should have been frontline HCWs during the pandemic era. The questionnaire was validated by a pre-test of responses of 10 frontline HCWs. This was to ensure the comprehensibility and validity of the questions. Thereafter, necessary corrections were made to the final questionnaire. Responses were collected with an Excel sheet (MicrosoftCorp., Redmond, WA), while data were analysed with SPSS version23 (IBM Corp., Armonk, NY) and GraphPad Prismversion 9.2.0(GraphPad Software, San Diego, CA). Results The targeted sample size was 400; however, 159 HCWs responded to the questionnaire and were thus included in the investigation. There were more male (60.4%) than female (39.6%) respondents, the majority of whom were Saudi nationals (86.6%) while the remaining were non-Saudi nationals working in the Kingdom. Also, 67% of the respondents were emergency medical service professionals while the remaining (23%) were primary healthcare professionals. Significantly, 71.8% of the respondents (p < 0.05) disagreed with adequate enumeration, rewards, and chances of promotion compared to those who agreed (28.2%) during the COVID-19 pandemic. Job satisfaction was not significantly correlated to gender or the work departments (p > 0.05). Respondents significantly (p < 0.05) agreed to the competence of their supervisors, and liked their colleagues and work environment. Conclusion The study has shown that although supervision during the pandemic era was with competence; however, hours of work put in by these frontline emergency professionals were not adequately remunerated. Also, the services they provide seemed not to have been appreciated and hence did not lead to promotion either. Therefore, there wasjob satisfaction.As expected, the workload was huge while chances of promotion were lacking. These observations could lead to a substandard service should there be another pandemic. There is a need for all stakeholders to look into this more cautiously should there be another pandemic.

Post-traumatic Stress Disorder and Its Associated Risk Factors Among Emergency Healthcare Workers: A Saudi Cross-Sectional Analytical Study.

Post-traumatic stress disorder (PTSD) is a psychiatric disease characterized by exposure to threatened death or serious injury and directly experiencing or witnessing the event. Many healthcare professionals have had PTSD, but emergency physicians may be particularly susceptible. To our knowledge, no study has been performed in Saudi Arabia to identify the prevalence and associated risk factors of PTSD among emergency staff. This study aims to determine the prevalence and risk factors of post-traumatic stress disorder (PTSD) among emergency healthcare workers (HCWs) in Saudi Arabia. A cross-sectional analytical study will be conducted in emergency departments around Saudi Arabia in all regions. The study population will include healthcare workers in emergency departments who work and presently live in Saudi Arabia. The survey was divided into two sections. The first section focuses on the emergency personnel's demographic data; the second concentrates on screening for post-traumatic stress disorder using the PTSD checklist for DSM-5 (PCL-5). Our population included 519 emergency healthcare staff, including males (51.4%) and females (48.6%). Most emergency HCWs worked in the Ministry of Health Hospitals (58%). The highest diagnosed psychological disorders among emergency staff were anxiety (19.3%) and mood disorders (10.2%). The prevalence of PTSD among emergency workers in Saudi Arabia was 14.1%. The prevalence of PTSD was significantly higher among emergency HCWs who had chronic diseases, emergency workers with anxiety or mood disorders, emergency staff who were using psychiatric medication (p<0.001), and those with psychotic disorders (p=0.002). The prevalence of PTSD among emergency healthcare workers in Saudi Arabia is estimated to be 14.1%, and pre-existing mental illnesses are associated with a higher risk of PTSD.

The Global Prevalence and Associated Factors of Burnout among Emergency Department Healthcare Workers and the Impact of the COVID-19 Pandemic: A Systematic Review and Meta-Analysis.

Emergency medicine (EM) settings are very stressful, given the high workload, intense working environment, and prolonged working time. In turn, the rate of burnout and its three domains have been increasingly reported among healthcare workers (HCWs). Therefore, we conducted this meta-analysis to determine the prevalence and risk factors of burnout among EM HCWs. Six databases were searched in February 2023, yielding 29 articles (16,619 EM HCWs) reporting burnout or its three domains (emotional exhaustion "EE", depersonalization "DP", and personal accomplishment "PA"). The primary outcome was the prevalence of burnout and its domains, while secondary outcomes included the risk factors of high burnout, EE, DP, or low PA. Burnout rates were pooled across studies using STATA software. The prevalence was measured using the pooled effect size (ES), and the random-effects model was used when heterogeneity was encountered; otherwise, the fixed-effects model was used. The prevalence of overall burnout was high (43%), with 35% of EM HCWs having a high risk of burnout. Meanwhile, 39%, 43%, and 36% of EM workers reported having high levels of EE and DP and low levels of PA, respectively. Country-specific changes in the rate of burnout were observed. The rate of high burnout, high EE, high DP, and low PA was higher during the COVID-19 pandemic as compared to the pre-pandemic period. The type of profession (nurses, physicians, residents, etc.) played a significant role in modifying the rate of burnout and its domains. However, gender was not a significant determinant of high burnout or its domains among EM workers. Burnout is a prevalent problem in emergency medicine practice, affecting all workers. As residents progress through their training years, their likelihood of experiencing burnout intensifies. Nurses are most affected by this problem, followed by physicians. Country-associated differences in burnout and its domains are evident.

Use of Information Systems in Emergency Department and employee satisfaction

Introduction: The existence and usage of an appropriately designed information system is obligatory for efficient function of the Emergency Department (ED). Purpose: Factors that determine Emergency Department workers’ satisfaction by Information System (IS) and the improvement measures that can be implemented. Material and Method: Non-experimental quantitative cross-sectional online study of 88 Emergency Department health care workers with questionnaire included from Nurses Attitudes Toward Computerization (NATC) by Brodt &amp; Stronge (1984) and End-User Computing Satisfaction by Bailey and Pearson (1983). The statistical package SPSS version 26 was used for data analysis and the level of statistical significance was set at 0.05. Results: Of 88 workers, 33 were male and 55 were female. The level of satisfaction was high in terms of reliability (M.T. 3.97) and low in terms of system operation speed (M.T. 3.25) and quality of support (M.T. 3.30). Demographic characteristics were not associated with attitudes toward PC use and satisfaction with the information system, while participant satisfaction was associated with the contribution of PCs to quality health care delivery and increased staff efficiency and capabilities (p&lt;0.01). The use of PCs appeared to contribute to the reduction of jobs positions (p=0.01) and to the increase of staff legal liability (p=0.01). Conclusions: Information Systems can contribute to the improvement of the working conditions of the EDs, to increase the efficiency, effectiveness and improvement of the quality care. The experience and training of the staff in the use of PCs plays a decisive role in the optimal utilization of the information systems.

Intersectional characterization of emergency department (ED) staff experiences of racism: a survey of ED healthcare workers for the Disrupting Racism in Emergency Medicine (DRiEM) Investigators.

The impact of racism on patient outcomes in Emergency Medicine has been examined but there have been few studies exploring the experiences of racism in health care workers. This survey aims to explore the experience of racism by interdisciplinary staff in a tertiary ED. By characterizing the staff experience of racism in the ED, we hope to inform the design of strategies to disrupt racism and ultimately improve the health and wellness of both staff and patients. We conducted a self-administered, cross-sectional survey to explore the reported experience of racism by healthcare workers in a single urban ED in an academic trauma centre. We employed classification and regression tree analyses to evaluate predictors of racism through an intersectional lens. A majority (n = 200, 75%) of all ED staff reported experiencing interpersonal racism (including physical violence, direct verbal violence, mistreatment and/or microaggressions) in the workplace. Respondents who identified as racialized self-reported significantly more racism at work than white respondents (86% vs. 63%, p < 0.001). Occupation, race, migrant status and age were identified through intersectional machine-learning models to be significantly predictive of the experience of racism. Nearly all respondents felt that the disruption of racism in Emergency medicine is important to them (90%, n = 207) and (93%, n = 214) were willing to participate in further training in anti-racism. Racism against interdisciplinary staff working in EDs is common and the burden on healthcare workers is high. Intersections of occupation, race, age and migrant status are uniquely predictive of the experience of racism for EM staff. Interventions to disrupt racism should be informed by intersectional considerations to create a safe working environment and target populations most at risk. ED healthcare workers are willing to take steps to disrupt racism in their workplace and need institutional support to do so.

Attitude and Perception Among Emergency Department Healthcare Workers on Organ Donation: A Multicenter Before and After Study

In the Philippines, organ donation is regulated under the Organ Donation Act (RA7170) and promoted by the Department of Health through the Philippine Network for Organ Sharing (PHILNOS). The number of organ donors to meet the increasing demand in the country continues to lag. The emergency department (ED) was identified in several foreign studies to be a significant source of successful organ donation. This action research project investigated the attitude and perception of 125 ED healthcare workers (HCWs) from three hospitals in Metro Manila before and after an awareness event. The study reveals that ED nurses and doctors are generally supportive and hold positive perceptions and attitudes toward organ donation. Despite the positive attitude, HCWs seem to be uncomfortable or unwilling to perform tasks important to organ donation such as approaching relatives and management of the deceased organ donor. Future training on organ donation will increase the positive attitude, confidence and likelihood to participate in organ donation and transplant activities. Key words: Organ Donation; Attitude and Perception; Emergency Department

Effects of mindfulness and meditation techniques on mental health of Emergency Department healthcare workers: a systematic review

Background: Working in the Emergency Department (ED) is linked to mental health effects, such as stress and burnout. Meditation and mindfulness are seen as ways of reducing the frequency and intensity of these issues. Objectives: To evaluate if meditation and mindfulness reduce the frequency of negative mental health outcomes among ED Healthcare Workers. Methods: We included studies in English which analyzed interventions using meditation or mindfulness and ED staff’s mental health outcomes. PubMed, SciELO and LILACS were used as databases. Results: 8 studies were included. Meditation techniques and outcomes evaluated were heterogeneous. Interventions were associated with reduced burnout, emotional exhaustion, or increased job satisfaction. Discussion: This study indicates that meditation and mindfulness decrease frequency and intensity of negative mental health outcomes among professionals in the ED. This review has limitations: some studies have methodological problems and limitations such as small sample size; measurements of outcomes were heterogeneous, and results are not always concordant. Studies with higher sample sizes and stricter methodology are needed for us to achieve conclusions about the effectiveness of these interventions.

Analysis of severe hand trauma injury frequency during “Munich’s Oktoberfest” within the last 9 years in comparison to years with absence due to the COVID-19 pandemic

IntroductionWithin its 2 week period, the Oktoberfest attracts around 6 million visitors yearly to Munich, Germany. Due to alcohol intake, congested halls, and disorderly activities, numerous accidents occur. Although many hand injuries are observed, the impact of Oktoberfest on severe hand trauma injury frequency is under investigated.Materials and methodsData from the regional emergency medical service (EMS) was analyzed over a 9 year period regarding the frequency of severe hand injuries during the world’s largest fair and compared to the corresponding period in the years 2020 and 2021 where the event was cancelled due to the world-wide COVID-19 pandemic. Additionally, we compared the patient numbers during the same period in one Emergency Department of a level-1-trauma and hand trauma center located close to the venue.ResultsAn exploratory description is made from data collected over a 9 year period (2013–2021) with focus on hand injuries before, during and after the “Oktoberfest”. A total of 4017 hand injuries were allocated to hospitals by EMS. There was an increase in severe hand injuries by 66% during the 2-weeks-Oktoberfest-period compared to years where the Oktoberfest did not take place. Pre-pandemic statistics show an increasing severe hand trauma frequency of 57.5% in September, compared to EMS-referrals during the remanding year.ConclusionThe risk of injuring relevant structures of the hand during Oktoberfest is extremely high as compared to other parts of the body due to beer stein and fall-associated injuries. These injuries can lead to lifelong impairments. Our data are the first that quantifies and pinpoints the risk of severe injury to the hand during Oktoberfest and therefore, it is of great interest for visitors, hand surgeons, paramedics and emergency department healthcare workers.

The Effectiveness of the Disaster Plan on the Incidence of COVID-19 in Emergency Department Staff of King Abdulaziz Medical City in Western Region

Background: Considering the rapid and emergent spread of coronavirus disease (COVID-19) or severe acute respiratory syndrome (SARS), hospitals were obligated to follow their emergency disaster plan [1]. This paper evaluates the effectiveness of the disaster plan based on the incidence of COVID-19 in emergency department (ED) staff of King Abdulaziz Medical City – Western Region (KAMC-WR) for one year. Methods: After reviewing the multidisciplinary management guidelines of COVID- 19, a cohort retrospective study was applied from March 2020 to March 2021 to measure the incidence of COVID-19 [2]. All emergency department health care workers (HCWs) were included in the study. Results: During the study period, results showed that 9 (4.24%) HCWs were infected by COVID-19 whereas 203 (95.75%) HCWs were not infected. The prevalence of COVID-19 among ED staff in KAMC-WR was low as compared to previous studies [3,4,5,6,7,8]. This indicates the effectiveness of KAMC-WR disaster plan. KAMC-WR disaster plan strategies that have been taken to lower the risk of infection transmission were discussed in this paper. Conclusion: In conclusion, this study showed beneficial strategies of KAMC-WR disaster plan that lowered COVID-19 incidence among ED staff.

Violence against healthcare workers in the emergency departments of Al-Madinah hospitals, Saudi Arabia.

Workplace violence (WPV) directed against healthcare workers (HCWs) in healthcare facilities has always been neglected. These occupational hazards have been investigated in recent times and received greater attention from decision-makers. This study aimed to assess the WPV committed against HCWs in the emergency departments (EDs). All the emergency department (ED) healthcare workers (HCW) in the hospitals of Al-Madinah Province, Saudi Arabia, were invited to participate in this cross-sectional study by completing an online questionnaire during May 15 to August 15, 2020. Information sought included characteristics of the participant and workplace, violence, the participants' responses and emotions, the consequences of the WPV incident, and the level of satisfaction with the management of the WPV incident. Data was analyzed using SPSS; Chi-square test was used to assess the association between WPV and various participant and workplace characteristics. Binary logistic regression analysis performed to identify independent predictors of work place violence. A total of 250 HCW filled the questionnaire. One-third of the participants were victims of at least one violent event, mostly nonphysical. The perpetrators were primarily the patient's companions, and a heavy workload/understaffing or an overcrowded environment was the main cause of the violence. The most frequent reaction was to call the hospital security. The emotions the participants experienced were disappointment, low self-esteem, and sadness. Most victims did not report the WPV incident because they believed that reporting was useless, insignificant, or they were fearful of adverse consequences. The rate of violence in EDs in Al-Madinah hospitals was lower than expected, and only 33.3% of HCWs had experienced a violent incident in the last year. However, there is a substantial margin for interventions to improve the situation and protect the HCWs in the EDs.

Humoral responses to the CoronoVac vaccine in healthcare workers.

This study aimed to assess the immunoglobulin G (IgG) antibody response rate in emergency department (ED) healthcare workers (HCWs) and potential adverse effects after CoronaVac vaccination. All included HCWs were grouped based on the previous history of coronavirus disease 2019 (COVID-19) and the number of vaccinations. Furthermore, the IgG antibody response was evaluated based on the sex and smoking status of HCWs. Those with a cut-off index of ≥1.00 after vaccination with CoronaVac were considered to have had COVID-19 and had an adequate humoral response. Among 224 ED HCWs, 18% experienced the adverse effects of CoronaVac vaccine, the most prevalent being pain in the injection site. The IgG antibody response rate was 20% after the first dose of vaccine, while the response rate increased to 90% after the second dose. Female HCWs had higher IgG response rates compared with male HCWs (53.8 [15.9-147.0] vs 31.2 [4.5-124.0]). Non-smokers had higher IgG response rate compared with smokers (49.0 [11.5-160.5] vs 23.1 [7.4-98.5]). A single dose of CoronaVac does not produce a sufficient antibody response; hence, two doses are recommended. Men have a lower IgG response compared with women. Smokers had a lower IgG response rate compared with non-smokers. Therefore, it may be necessary to carefully assess the humoral responses of men and smokers when implementing a community vaccination program.