Safety Of Healthcare Workers Research Articles

Needle-stick Incidents among Nurses: Knowledge, Attitude, and Practices in the Workplace

This cross-sectional study assessed the knowledge, attitudes, and practices of nurses regarding needle-stick injuries (NSIs) in a public hospital in Kuala Lumpur, Malaysia. The majority of nurses exhibited good awareness of NSIs and related infections. Concerns about NSIs and sharps disposal containers were common among nurses. Most nurses practiced safe handling and disposal of needles but had room for improvement in consistent glove usage and adherence to post-exposure prophylaxis. Targeted interventions and educational programs are needed to enhance knowledge, attitudes, and practices, ensuring better workplace safety for healthcare workers and reducing the risk of blood-borne pathogen transmission.

3D printers in hospitals: Reducing bacterial contamination on 3D-printed material

Background: COVID-19 has presented hospitals with unique challenges. An SHEA Research Network survey showed that 40% reported “limited” or worse levels of personal protective equipment (PPE) and that 13% were self-producing PPE to address those deficits, including 3D-printed items. However, we do not know how efficiently, if at all, 3D-printed materials can be disinfected. Additionally, 2 filaments, PLACTIVE and PUREMENT, claim to be antimicrobial; they use copper nanocomposites and silver ions to reduce bacterial populations. We assessed how PLACTIVE and PUREMENT may be contaminated and how well they reduce contamination, and how readily polylactic acid (PLA), a standard 3D-printed material, may be disinfected. Methods: We grew methicillin-resistant and -susceptible Staphylococcus aureus, Escherichia coli, and Klebsiella pneumoniae on 3D-printed disks and conducted bacterial survival assays to determine whether bacteria grow on PLA, PLACTIVE, and PUREMENT. We performed a time series (with 3- and 24-hour dry times) followed by serial dilutions to attain colony-forming unit (CFU) averages for each strain per disk. To determine whether 3D-printed material can be cleaned, we used 70% EtOH on PLA only. We conducted the same time series followed by a disinfectant time series (with dry times 30 seconds, 2.5, minutes, 5 minutes, and 10 minutes). Again, serial dilutions were performed to attain the PLA CFU averages with disinfectant. The CFU averages from the control group (PLA) and testing group (PLACTIVE and PUREMENT) were compared to see how well the antimicrobial material decreased bacterial load. We also compared the CFU averages of PLA with and without disinfectant to see how well 70% EtOH decreased bacterial load. Results: 3D-printed material is readily contaminated with bacteria common in hospitals and can sustain that contamination. Antimicrobial materials, PLACTIVE and PUREMENT, had lower levels of bacterial contamination when compared to PLA. However, disinfected disks had lower overall CFU averages than those that were not, but the level of disinfection was variable and bacterial populations recovered hours after disinfection application. Conclusions: Proper disinfection and using appropriate 3D-printed materials are essential to limiting bacterial contamination. 3D printers and their products can be invaluable for hospitals, especially when supplies are low and healthcare worker safety is paramount. Environmental services should be made aware of the presence of antimicrobial 3D-printed materials, and patients should be discouraged from printing their own items for use in hospital environments.Disclosures: None

국가 감염병 대응을 위한 이동형 음압격리병실 개발 및 감염방지 환기성능 평가에 관한 연구

In this paper, we propose a mobile negative pressure isolation room to ensure the safety of healthcare workers (HCWs) and provide rapid medical service, and analyze the performance of a ventilation system that can minimize virus cross-contamination through numerical analysis. The negative pressure isolation room uses a ventilation system with air flowing from the HCWs to the patient, a clean-contaminated zone separation, and pressure differential control applied to the anteroom/isolation room. CFD) simulation results showed that the negative pressure isolation room, which needs to maintain negative pressure, can prevent cross-infection by using a ventilation system with a rate of 6 ACH and maintaining a pressure differential of -2.5 Pa or higher with the anteroom/corridor, regardless of toilet exhaust operation. It is recommended to operate the toilet exhaust at all times to maintain the pressure differential in the existing hospital rooms. However, the independently configured mobile negative pressure isolation room operates efficiently even if the toilet exhaust fan is not in operation, making it a more energy and noise-efficient option.

Comprehensive Evaluation of Occupational Accidents in a Hospital Setting: Insights from L-Type Matrix and Fine-Kinney Risk Assessment Methods

Objective: The objective of this study was to comprehensively evaluate occupational accidents in a hospital setting using the L-Type matrix and Fine-Kinney risk assessment methods. The aim was to assess the frequency, severity, and associated risks of different types of accidents. Methods: This single-center observational study analyzed occupational injuries that occurred to hospital employees between January 2018 and December 2022 in Arnavutköy State Hospital. Data were obtained from hospital records using a hospital information management system. Demographic characteristics, accident types, previous accident history, incapacity reports, L-Type matrix scores, and Fine-Kinney method scores were recorded. Risk scores were categorized based on predefined criteria. Results: The study included 249 occupational accidents, with a mean age of 30.94±9.69 years. Needle stick injuries in the hand were the most common type of accident (72.7%), followed by falls and bumps (16.1%). The L-Type matrix assessment showed that 90% of accidents were mild, and none were severe. According to the Fine-Kinney method, 0.8% of accidents were in the very high-risk group. Multiple accidents were observed among 23.7% of employees, and 11.6% resulted in work disability reports. Conclusion: Occupational accidents pose a significant risk to the safety and well-being of healthcare workers in hospitals. Needle stick injuries and falls or collisions were the most prevalent accidents. The use of risk assessment methods such as the L-Type matrix and Fine-Kinney approach allows for a comprehensive evaluation of occupational risks.

Future COVID-19 Booster Vaccine Refusal in Healthcare Workers after a Massive Breakthrough Infection Wave, a Nationwide Survey-Based Study.

Background: An unprecedented coronavirus disease 2019 (COVID-19) wave occurred in China between December 2022 and January 2023, challenging the efficacy of the primary series of COVID-19 vaccines. The attitudes toward future COVID-19 booster vaccines (CBV) after the massive breakthrough infection among healthcare workers remain unknown. This study aimed to explore the prevalence and determinants of future CBV refusal after the unprecedented COVID-19 wave among healthcare workers. Methods: Between 9 and 19 February 2023, a cross-sectional nationwide online survey was conducted using a self-administered questionnaire vaccine among healthcare workers in China. Sociodemographics, profession, presence of chronic medical conditions, previous COVID-19 infection, attitudes towards future CBV, and reasons for future CBV refusal were collected. We estimated odds ratio [OR] with 95% confidence interval [CI] using a multivariable logistic regression model to explore the factors associated with future CBV refusal. Results: Among the 1618 participants who completed the survey, 1511 respondents with two or more doses of COVID-19 vaccines were analyzed. A total of 648 (41.8%) of respondents were unwilling to receive a future CBV. Multivariable logistic regression analysis revealed the association of CBV refusal with profession (vs. other staff, physician-adjusted OR 1.17, 95%CI 0.79-1.72, nurse-adjusted OR 1.88, 95%CI 1.24-2.85, p = 0.008), history of allergy (adjusted OR 1.72, 95%CI 1.05-2.83, p = 0.032), a lower self-perceived risk of future COVID-19 infection (p < 0.001), and a lower belief in CBV effectiveness (p = 0.014), safety (p < 0.001), and necessities for healthcare workers and the public (p < 0.001, respectively). Conclusions: Our findings highlight that a considerable proportion of healthcare workers were against a future booster dose after an unprecedented COVID-19 wave. Self-perception of future COVID-19 risk, and potential harm or doubtful efficacy of vaccines are the main determinants. Our findings may help public health authorities to establish future COVID-19 vaccination programs.

The Occupational Safety and Health Protection for Health Workers during the Covid-19 Pandemic at AMC Hospital Yogyakarta

The Corona Virus Disease 2019 (Covid-19) pandemic has affected almost all sectors, especially health sector. Standing in the forefront in handling the Covid-19 patients, healthcare workers are exposed to the high risk of virus transmission. Therefore, Occupational Safety and Health (OSH) protection of healthcare workers should also get serious attention from various parties, especially employers. AMC hospital is one of the healthcare facilities in Yogyakarta that is engaged in the fight against the Covid-19 outbreak. The aim of this research is to explore the way AMC Hospital implement the occupational safety and health protection for its healthcare workers during the Covid-19 Pandemic. The type of this research is empirical legal research which examines the application of relevant legal provisions in regard to the issue of occupational safety and healthcare protection for healthcare workers in AMC Hospital Yogyakarta. The results of the study show that AMC hospital successfully implemented OSH during the pandemic in an effort to protect healthcare workers. Further, Occupational Diseases (PAK) caused by Covid-19 are covered by the Work Accident Insurance (JKK) program and the Social Health Insurance Administration Body (BPJS) in compliance with legal requirements.

A New Model for a Sustainable Healthcare Supply Chain Prioritizes Patient Safety: Using the Fuzzy Delphi Method to Identify Healthcare Workers’ Perspectives

The pandemic crisis and the resulting global uncertainties have obviously had a severe impact on the healthcare supply chain (HSC), leading scholars, healthcare executives, and policymakers to focus on the sustainability of the HSC. Technologies have emerged and developed rapidly in recent years, especially in the healthcare industry, for coping with the pandemic crisis and supporting the “new normal” for humankind. Within this context, various new technologies have been implemented to maximize the supply chain process, ensure patient and healthcare worker safety, and improve the quality of care. Hence, the integration of a technological dimension with the traditional three pillars of sustainability may aid in attempts to define the potential attributes of these dimensions of sustainability. Therefore, this study aimed to identify the key attributes of a sustainable healthcare supply chain (SHSC), and this paper presents a new, four-dimensional model for SHSCs, consisting of social, environmental, economic, and technological dimensions. A systematic literature review was conducted, resulting in the identification of 35 potential SHSC attributes. The Fuzzy Delphi Method (FDM) was then applied to determine the appropriateness of these potential attributes according to the consensus of 13 experts, including healthcare workers in a variety of medical specialties, who profoundly understand HSC sustainability. The results yielded 22 appropriate attributes, which were then categorized across the four dimensions. Consequently, a new model of an SHSC, which prioritizes patient safety, was constructed and is proposed here. This SHSC model can be applied strategically to the healthcare industry to enhance the safety of both medical personnel and patients in a sustainable manner.

Prospect and Application of Medical Robots in the Context of Epidemic

Under the background of the modern epidemic, where exposed the disadvantages of epidemic prevention, and the safety of health care workers cannot be guaranteed, the medical efficiency can't satisfy people's basic needs, it also cannot reasonable allocation of medical resources. The robot by its efficient characteristics will assume greater responsibility. This article based on the current domestic and international policies and forms to analyze the key technology of the current medical robot. Several types of medical assistant robot in the market are analyzed, the advantages and disadvantages of the robot are given, some suggestions for improvement are put forward, the future development prospect of the robot is analyzed and the market is prospected. Through a series of investigations and studies, it is found that the medical robot can indeed play a very good help to the medical staff, and optimize the nucleic acid process. Moreover, it can effectively protect the safety of medical staff, reduce the possibility of novel coronavirus transmission, save people's time and improve handling efficiency. However, due to the insufficient development of the Internet technology in the past, there are still some problems in these robots. In conclusion, Robots are highly efficient, need less rest time than humans and have a lower probability of making mistakes.

Global conflict escalation during the pandemic, climate, and economic dilemmas: Healthcare sustainability challenges in conflict zones and elsewhere

Religion, governance, and politics–as well as related topics such as human rights, justice, and so on–have historically caused many of the world’s most significant conflicts, and they continue to do so because these issues are often the most fundamental in the structure of a society. To gain a military advantage, parties to armed conflicts have polluted water, burned crops, cut down forests, poisoned soils, and killed animals over the years. A variety of context factors, particularly socioeconomic conditions, governance, and political factors, interact and play a key role in translating climate change into conflict risks. The present unrest all over the world risks putting more than half of the countries into a crisis of health, economy, and social safety, which is the biggest threat to human civilization. The security and safety of healthcare facilities, workers, and supply lines remain paramount concerns along with access to health services, technology, and innovation.

Occupational Exposure to Infectious Diseases among Health Workers: Effects, Managements and Recommendations

Healthcare professionals work with patients in settings that are regarded as some of the highest-risk workplace conditions. Healthcare workers' lives, safety, and well-being are in danger due to occupational risks such biological, chemical, physical, ergonomic, psychological, fire and explosion, and electrical dangers. According to estimates, 1 in 10 healthcare professionals worldwide get a sharp injury each year.

Process Evaluation of Decontamination, Cleaning and Sterilization of Medical Instruments at Public Health Centers of Mekelle Zone, Tigray, Ethiopia, 2018

Background: Today Health Care Associated Infections are the major public health problems in majority of developing world including Ethiopia. The use of disposable equipment is the best way to ensure patient comfort and security, however, low income country health system could not acquire disposable format for certain devices due to the cost. Then some instruments need to be sterilized for re-use. In this study we have evaluated the sterilization status of medical instruments. Method: Descriptive study design was employed in this evaluation study. The evaluation was conducted in 147 health care workers and nine public health centers of Mekelle zone from January to June, 2017. Systematic random sampling method was conducted to select study participants. In the quantitative part, observation of health care workers’ practice and availability of materials were conducted using checklists. As a complement, key informant interviews were also conducted. Collected quantitative data were checked, coded and entered into SPSS version 20 for analysis. Frequencies, Mean, percentage, tables were used for results presentation. Result: Availability, compliance and safety of health care workers’ dimensions were used to evaluate the implementation of the intervention. Accordingly, availability of resources in the studied health centers has been rated as good (74.2%). And compliance level of health care workers has found to be fair (66.1%). However, practice of safety by the health care workers has found to be poor (48%). Conclusion: According the judgment criteria, the overall implementation status of decontamination, cleaning and sterilization service has been rated as fair (63.4%).

The need to nurture Aotearoa New Zealand's healthcare workforce.

This commentary examines the ethical significance of recently published research demonstrating the extent to which healthcare workers experienced stress and increased challenges in the workplace due to inadequate access to personal protective equipment (PPE) during the first COVID-19 surge in Aotearoa New Zealand. The inadequate state of New Zealand's PPE stockpile and distribution system at the beginning of the pandemic was a critical signal, a "canary in the coalmine", of broader challenges facing the New Zealand healthcare system, particularly for healthcare worker safety and wellbeing. As New Zealand reforms its health system with the aim of improving access to and equity of care, an opportunity exists to apply critical lessons learnt from the COVID-19 pandemic about the need to prioritise the wellbeing of the healthcare workers we are dependent upon to deliver that care. Failure to apply this new knowledge will see the system similarly unprepared for future public health emergencies, which are likely to be imminent, and potentially with healthcare workers less willing to accept the burdens placed on them. The Nurture Framework, which has emerged from the voices of healthcare workers within this research, should be adopted as part of health reforms and ongoing emergency preparedness planning. Trust, transparency, respect and safety, the four values of the Framework, are fundamental for all workers who contribute their skills, knowledge and time to our healthcare organisations.

Exposure risk management: Personal protective equipment and the risk of accidents occurring during aerosol generating procedures applied to COVID-19 patients.

COVID-19 is considered to be very contagious as it can be spread through multiple ways. Therefore, exposure risk of healthcare workers (HCWs) treating COVID-19 patients is a highly salient topic in exposure risk management. From a managerial perspective, wearing personal protective equipment and the risk of accidents occurring during aerosol generating procedures applied to COVID-19 patients are two interconnected issues encountered in all COVID-19 hospitals. The study was conducted to understand the realistic impact of exposure risk management on HCWs exposed to risks of SARS-CoV-2 virus infection in a healthcare unit. In particular, this study discusses the role of personal protective equipment (PPEs) used in aerosol generating procedures (AGPs) to protect HCWs, and the related risk of accidents occurring when performing AGPs. This is a cross-sectional single-hospital study conducted at the "Sf. Ioan cel Nou" Hospital in Suceava, Romania, that had to ensure safety of healthcare workers (HCWs) getting in contact with COVID-19 cases. Data used in the study were collected between 10.12.2020-19.03.2021 by means of a questionnaire that collected information on risk assessment and healthcare workers' exposure management, and which was translated and adapted from the World Health Organization (WHO) and applied to respondents online. For this purpose, ethical approval was obtained, doctors and nurses from all hospital departments being invited to complete the questionnaire. Data processing, as well as descriptive, correlation and regression analyses have been done by using the 21.0 version of the Statistical Package for Social Sciences software. Most of the 312 HCWs reported having always used disposable gloves (98.13%), medical masks N95 (or equivalent) (92.86%), visors or googles (91.19%), disposable coverall (91.25%) and footwear protection (95.00%) during AGPs. The waterproof apron had always been worn only by 40% of the respondents, and almost 30% of staff had not used it at all during AGPs. Over the last three months, the period when the questionnaire was completed, 28 accidents were reported while performing AGPs: 11 accidents with splashing of biological fluids/ respiratory secretions in the eyes, 11 with splashing of biological fluids/ respiratory secretions on the non-idemn skin, 3 with splashing of biological fluids/ respiratory secretions in the oral/ nasal mucosa and 3 with puncture/ sting with any material contaminated with biological fluids/ respiratory secretions. Also, 84.29% of respondents declared having changed their routine, at least, moderately due to COVID-19. An effective risk exposure management is based on wearing protective equipment. The only protection offered by the disposable coverall, as it results from our analysis, is related to splashing of biological fluids/ respiratory secretions on the non-idemn skin. In addition, the results show that the number of accidents should decrease due to the fact that disposable gloves and footwear protection are used while performing AGPs on patients with COVID-19 and hand hygiene is practised before and after touching a patient with COVID-19 (regardless of glove wearing).

Safety of Health Care Workers A Priority for Patient Safety

Background: Worldwide healthcare workforce represents 12%, in Uganda, out of the 39000 healthcare workers (HCW), 500 have been deployed at Mbale regional referral hospital (MRRH). The deficient quality service delivery is attributed to adverse occupational health risk that are not addressed and acknowledged posing a great risk to patient safety. Study aims to investigate the unsafe acts and unsafe working conditions of health care workers at (MRRH).Methods: A quantitative observational study with a cross-section design was used using and a semi structured observation checklist for data collection among 120 health care workers of MRRH.Result: 45(37.5%) of the HCW never wore the necessary PPEs versus 75(62.5%) who wore, almost half 55(45.3%) worked over time and 65(54.6%) did not, as well the same figures represent those who over worked and those who did not over work respectively. 70% of the working places had defective working conditions for example no lighting, slippery floors and no danger signs. 75% of the wards had improper waste segregation measures.Conclusion : HCW and institutions should intervene to mitigate the hazards, strengthening occupational health, patient safety, hazard prevention and control

Clinical Nurse Specialist and Clinical Nurse Leader Collaboration During the COVID-19 Pandemic.

The aim of this study was to describe an innovative strategy to maintain healthcare worker safety and optimal patient outcomes that was implemented by a healthcare system in the Southeastern United States during the COVID-19 pandemic. During the surges of the COVID-19 pandemic, healthcare systems have struggled with healthcare worker burnout, high staff turnover rates, and redeployment of staff to unfamiliar areas and the uncertainty regarding COVID-19 personal protection and patient care. Clinical nurse specialist/clinical nurse leader teams were created to help ensure healthcare worker safety and optimize patient care outcomes. Healthcare worker safety and desired patient outcomes were maintained. Throughput was expedited for emergency department patients, and there was timely implementation of therapeutic modalities for critically ill patients. Clinical nurse specialist/clinical nurse leader team collaboratively cross-trained staff to ensure their safety and delivery of quality patient care. The team was pivotal in helping safeguard staff from harm while optimizing patient outcomes. Lessons learned will help us in future disasters as well as our daily operations.

Prevalence of Noise Induced Hearing Loss in Industrial Workers of Taxila

Background: Occupational hazards and risks are a common public health issue, especially when healthcare workers safety is concerned; Noise induced hearing loss is a common preventable occupational hazard which affects millions of people globally1. It is the hearing loss that is caused by prolonged exposure of the ear to the noise2. Aim: To identify prevalence of Noise induced hearing loss in industrial workers from July 1, till December 31st, 2021 Study design: Descriptive, cross-sectional study Place and duration of study: The current study was conducted at Taxila at HITEC-Institute of Medical sciences from July 1, till December 31st, 2021. Methodology: A total number of 314 workers working in industrial area with noisy surroundings according to the selection criteria were included in the study. A questionnaire about past medical history of all participants in regard to ear and hearing disorders was obtained. Prevalence of NIHL was assessed in all workers with or without hearing loss. Results: The total numbers of workers included in the study were 314. The total number of patients having NIHL was 42. Prevalence of NIHL was 13. NIHL is a global health problem and is the second most important cause of hearing loss. It is a preventable disorder that affects a large proportion of workers. In our setup the NIHL was lower than expected due to better control of Noise and proper use of noise protective equipment. Keywords: NIHL = Noise-induced Hearing Loss, sensorineural hearing loss, Hearing loss.

Doffing Corridor: Establishing Expedited High-Volume Doffing With Exposure Reduction to Contaminated Personal Protective Equipment (PPE) in a COVID-19 Hospital in India.

Background Considering the virulent nature of the COVID-19, the safety of healthcare workers (HCW)became a challenge for hospital administrators. Wearing a personal protective equipment (PPE) kit, called donning, which can be easily done by the help of another staff.But correctly removing the infectious PPE kit (doffing) was a challenge. The increased number of HCWs for COVID-19 patient care raised the opportunity to develop an innovative method for the smooth doffing of PPEs. Objective We aimed to design and establish an innovative PPE doffing corridor in a tertiary care COVID-19 hospital during the pandemic in India with a heavy doffing rate and minimize the COVID-19 virus spread among healthcare workers. Methodology A prospective, observational cohort study at the COVID-19 hospital, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India, was conducted from July 19, 2020, to March 30, 2021. The time taken for PPE doffing process of HCWs was observed and compared between the doffing room and doffing corridor. The data was collected by a public health nursing officer using Epicollect5 mobile software and Google forms. The following parameters, like grade of satisfaction, time and volume of doffing, the errors in the steps of doffing, rate of infection, were compared between the doffing corridor and the doffing room. The statistical analysis was done by the use of SPSS software. Result 'Doffing corridor' decreased the overall doffing time by 50% compared to the initial doffing room. The doffing corridor solved the purpose of accommodating more HCWs for PPE doffing and an overall saving of 50% time. Fifty-one percent of HCWs rated the satisfaction rate as Good in the grading scale. The errors in the steps of doffingthat occurred in the doffing process were comparatively lesser in the doffing corridor. The HCWs who doffed in the doffing corridor were three times less likely to get self-infection than the conventional doffing room. Conclusion Since COVID-19 was a new pandemic, the healthcare organizationsfocused on innovations to combat the spread of virus. One of these was an innovative doffing corridor to expedite the doffing process and decrease the exposure time to the contaminated items. The doffing corridor process can be considered at a high-interest rate to any hospital dealing with infectious disease, with high working satisfaction, less exposure to the contagion, and less risk of infection.

Surgical Protocols before and after COVID-19-A Narrative Review.

The COVID-19 epidemic has affected not only people's daily lives but also the working methods of clinicians, surgical procedures, open/minimally invasive procedures, operating room management, patient and healthcare worker safety, education and training. The main objective of this study was to review selected articles and determine the changes in the general surgery protocols/procedures before and after the emergence of the COVID-19 pandemic. The literature was carried out in PubMed-Medline, Cochrane Library, Embase, Scopus and Google Scholar. The terms utilised for the searches were "SARS-CoV-2", "Surgery", "COVID-19", "Surgical protocol", "Surgical recommendations" and "before and after". A total of 236 studies were identified, out of which 41 studies were included for data extraction. Significant changes in all the articles were observed with respect to the surgeries done before, during and after the COVID-19 pandemic. Specifically, the number of elective surgeries were considerably fewer in comparison to the pre-pandemic period. Since the COVID-19 pandemic started, hospitals all throughout the world have conducted significantly fewer procedures, particularly elective/non-urgent surgeries.

SARS-CoV-2 Antibody Dynamics in Healthcare Workers after mRNA Vaccination.

Since the emergence of SARS-CoV-2, maintaining healthcare worker (HCW) health and safety has been fundamental to responding to the global pandemic. Vaccination with mRNA-base vaccines targeting SARS-CoV-2 spike protein has emerged as a key strategy in reducing HCW susceptibility to SARS-CoV-2, however, neutralizing antibody responses subside with time and may be influenced by many variables. We sought to understand the dynamics between vaccine products, prior clinical illness from SARS-CoV-2, and incidence of vaccine-associated adverse reactions on antibody decay over time in HCWs at a university medical center. A cohort of 296 HCWs received standard two-dose vaccination with either bnt162b2 (Pfizer/BioNTech) or mRNA-1273 (Moderna) and were evaluated after two, six, and nine months. Subjects were grouped by antibody decay curve into steep antibody decliners gentle decliners. Vaccination with mRNA-1273 led to more sustained antibody responses compared to bnt162b2. Subjects experiencing vaccine-associated symptoms were more likely to experience a more prolonged neutralizing antibody response. Subjects with clinical SARS-CoV-2 infection prior to vaccination were more likely to experience vaccination-associated symptoms after first vaccination and were more likely to have a more blunted antibody decay. Understanding factors associated with vaccine efficacy may assist clinicians in determining appropriate vaccine strategies in HCWs.

Establishing local manufacture of PPE for healthcare workers in the time of a global pandemic

A face shield is a secondary personal protective equipment (PPE) for healthcare workers (HCW). Worn with the appropriate face masks/respirators, it provides short term barrier protection against potentially infectious droplet particles. Coronavirus disease 2019 (COVID-19) caused a spike in demand for PPE, leading to a shortage and risking the safety of HCW. Transport restrictions further challenged the existing PPE supply chain which has been reliant on overseas-based manufacturers. Despite the urgency in demand, PPE must be properly tested for functionality and quality. We describe the establishment of local face shields manufacture in Western Australia to ensure adequate PPE for HCW. Ten thousand face shields for general use (standard) and for ear, nose and throat (ENT) specialist use were produced. Materials and design considerations are described, and the face shields were vigorously tested to the relevant Standards to ensure their effectiveness as a protective barrier, including splash and impact resistance. Comparative testing with traditional and other novel face shields was also undertaken. Therapeutic Goods Administration (TGA) licence was obtained to manufacture and supply the face shields as a Class I medical device. The swiftness of process is a credit to collaboration from industry, academia and healthcare.