Safety Of Healthcare Workers Research Articles

Protecting workers' well-being in times of crisis: the first wave of COVID-19 in an Australian healthcare setting in 2020

PurposeThe COVID-19 pandemic continues to challenge healthcare systems worldwide. The authors examined the lived experiences and perceptions of healthcare workers (HCWs) in managerial and senior positions to explore the pandemic's effects on well-being and valued organisational responses.Design/methodology/approachUsing purposive sampling, the authors conducted 39 semi-structured interviews with senior staff including health service administrators, heads of department and senior clinicians at a designated COVID-19 facility in New South Wales, Australia. Interviews were conducted from November 2020 to February 2021 to reflect on experiences during the height of the pandemic in 2020 (mid-March to the end of May 2020).FindingsWorkplace experiences affecting HCWs' well-being included being shunned by others, fear of infecting family, fear of the unknown, concerns about personal protective equipment, lack of direction from above and increased workload. Organisational interventions to protect the health and safety of HCWs and their patients included redeployment, improved communication, effective management committees, education and mental health supports.Practical implicationsOrganisations can minimise worker-identified factors threatening their well-being during a health crisis by applying broad-ranging initiatives including inclusive and open communication, promoting flexible work practices, providing up-to-date guidelines and policies and fostering camaraderie between workers.Originality/valueThe voices of senior clinical and managerial staff have been largely unheard during the COVID-19 pandemic. The authors addressed this deficit by describing their experiences and insights regarding the pandemic's impact on well-being and the organisation's responses to simultaneously safeguarding its staff and providing quality patient care.

Occupational health and safety hazards faced by health care professionals in Kathmandu based hospital: a cross-sectional analytical study

Background: Occupational health and safety is a broad discipline that covers several specialized fields, including physical, psychological, chemical, biological, and mechanical/electrical, and assesses the health and safety of employees in a broader context. Healthcare workers including physicians and nurses get regularly exposed to occupational hazards. The objective of the study was to analyse the occupational health and safety hazards faced by healthcare professionals in Kathmandu. Methods: A quantitative cross-sectional analytical study was conducted in the hospitals of the Kathmandu district. Ethical approval was taken from National Academy for Medical Sciences and hospitals. Purposive sampling was used to select the hospitals and convenience sampling was used to collect the data from respondents using semi-structured questionnaires. The total sample size was 247. Data collected from respondents were entered into Epidata and were analysed and expressed using SPSS version 25. Results: Back pain (64.8%) and needle injury (59.5%) were the most perceived injury that might occur in hospitals along with hepatitis B (35.2%) and covid (23.9%) as infections. The majority (88.7%) of health workers used PPE while working and biological hazards (88.3%) were the most suffered hazards followed by chemical hazards (87%). The age group of 50-60 years, higher secondary level graduates, government health workers, doctors, and nurses were statistically significant with safety practices whereas Buddhist, married participants, governmental health workers, nurses, and radiologists were associated with hazards. Conclusions: The development and updates of existing policy on OHS and training/workshop, exposure to information, and awareness are necessary for improving occupational health and safety of health care workers in Kathmandu valley.

Health and safety of Covid-19 frontline healthcare workers: A case of Masvingo Urban, Zimbabwe

Health and safety of Covid-19 frontline healthcare workers: A case of Masvingo Urban, Zimbabwe

Filtration performance, fit test and side effects of respiratory personal protective equipment following decontamination: Observations for user safety and comfort.

While facing personal protective equipment (PPE) shortages during the COVID-19 pandemic, several institutions looked to PPE decontamination and reuse options. This study documents the effect of two hydrogen peroxide treatments on filtration efficiency and fit tests as well as the side effects for volunteers after the decontamination of N95 filtering facepiece respirators (FFRs). We also propose an efficient and large-scale treatment protocol that allows for the traceability of this protective equipment in hospitals during PPE shortages. The effects of low-temperature hydrogen peroxide sterilization and hydrogen peroxide vapor (HPV) on two FFR models (filtration, decontamination level, residual emanation) were evaluated. Ten volunteers reported comfort issues and side effects after wearing 1h FFRs worn and decontaminated up to five times. The decontamination process does not negatively affect FFR efficiency, but repeated use and handling tend to lead to damage, limiting the number of times FFRs can be reused. Moreover, the recommended 24-h post-treatment aeration does not sufficiently eliminate residual hydrogen peroxide. Prolonged aeration time increased user comfort when using decontaminated FFRs. HPV and low-temperature hydrogen peroxide sterilization seem to be appropriate treatments for FFR decontamination when the PPE is reused by the same user. PPE decontamination and reuse methods should be carefully considered as they are critical for the comfort and safety of healthcare workers.

GLOBAL HEALTH ISSUES WITH CONFLICT ESCALATION AMONG PANDEMIC, CLIMATE, AND ECONOMIC CRISES

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 remains the most constant threat to human civilization. The security and safety of health-care facilities, workers, and supply lines remain paramount concerns, along with access to health services, technology, and innovation.

The safety, health, and well-being of healthcare workers during COVID-19: A scoping review.

The outbreak of the COVID-19 pandemic has affected the safety and well-being of healthcare workers. A scoping review was conducted to highlight the impact of COVID-19 on the safety, health, and well-being of healthcare workers and to shed light on the concerns about their perceived safety and support systems. A literature search was conducted in three different databases from December 1, 2019, through July 20, 2022, to find publications that meet the aim of this review. Using search engines, 3087 articles were identified, and after a rigorous assessment by two reviewers, 30 articles were chosen for further analysis. Two themes emerged during the analysis: safety and health and well-being. The primary safety concern of the staff was mostly about contracting COVID-19, infecting family members, and caring for patients with COVID-19. During the pandemic, the health care workers appeared to have anxiety, stress, uncertainty, burnout, and a lack of sleep. Additionally, the review focused on the suggestions of health care providers to improve the safety and well-being of workers through fair organizational policies and practices and timely, individualized mental health care.

COVID-19 and health care worker exposure at Chris Hani Baragwanath Academic Hospital

Abstract Background: Health care workers (HCWs) are at increased risk of coronavirus disease 2019 (COVID-19). Appropriate risk assessments and testing are essential to reduce transmission and avoid workforce depletion. Objective: To investigate the risk of COVID-19 infection among HCWs who fulfil the person under investigation case definition or had exposure to a confirmed COVID-19 contact. Methods: We conducted a retrospective review of HCWs who were exposed to and/or tested for COVID-19 during the first wave of the pandemic. Data collected included demographics, exposure type, risk level, and COVID-19 test result. Frequency distribution tables, bivariate analyses, univariate and multivariate analyses were conducted. Results: Among the 1111 HCWs reviewed, 643 were tested with 35.6% positive results. PUI's accounted for 62.4% of positive cases. Symptomatic HCWs with no known contact were at a greater risk of infection than those with a patient exposure (p═0.001). The risk of testing positive was higher after a patient exposure (p═0.000) compared to a co-worker contact. Patient-facing designations had a higher risk of SARS-CoV-2 infection than non-clinical designations (p═0.013). The exception to this was security personnel who were 28 times more likely to test positive than any other designation (p═0.000). Conclusion: There is a higher positivity rate among HCWs than the general population. The presence of symptoms warrants testing. Nosocomial transmission was derived from patients more than co-worker contacts. Precautions in the workplace need to be reinforced to protect the health and safety of HCWs during this pandemic. These findings should assist with preparedness for future pandemics.

The Business Case for Addressing Burnout in Frontline Leaders: A Toolkit of Interventions From Nurse Executives Around the United States.

In 2019, the National Academy of Sciences, Engineering, and Medicine identified clinician burnout as a major problem that required immediate action because of its threat to both health care worker safety and patient safety. Unfortunately, the rise of COVID-19 in 2020 with no signs of a clear ending (as of the summer of 2022) has compounded this problem. Consequently, much focus has been placed by many to address clinician burnout and help alleviate this major threat to safety. Unfortunately, compared with clinician burnout, articles and resources to address frontline leader (FL) burnout are fewer. FLs are key to supporting teams and are integral to their success. They also execute and operationalize organizational strategic plans to ensure patient safety at the point of care. The burnout issue with bedside clinicians is a big issue, a fractured fault line in our health care system. However, without addressing the well-being of FLs, this fault line becomes a chasm. The column shares background from the American Organization for Nursling Leadership longitudinal studies and other pertinent research. It also provides examples of practices across the nation of how nurse executives are supporting their teams and promoting leader support and well-being.

Drug-Resistant Tuberculosis Stigma Among HealthCare Workers Toward the Development of a Stigma-Reduction Strategy: A Scoping Review.

Drug-resistant tuberculosis (DRTB) is a growing concern worldwide. The poor rate of service delivery exacerbates the severity, leading to an increase in community transmission, which is further amplified by stigma. Health care workers (HCWs) are at the forefront lines of service delivery; their efforts are suspected of resulting in stigmatization, negatively impacting patient-centered care. However, little is known about DRTB-related stigma among these HCWs, and interventions are limited. Our scoping review is significant because it provides an overview of the DRTB stigma confronting HCWs and informs subsequent stigma-reduction initiatives. Utilizing Arksey and O'Malley framework, we exhaustively searched electronic databases for relevant English-language studies published from 2010 to 2022, identifying the drivers and facilitators of DRTB-related stigma among HCWs from high-TB and -DRTB burden countries, and compiling recommendations that could reduce DRTB stigma. From 443 de-duplicated papers, 11 articles on HCWs' DRTB-related stigma were reviewed and synthesized. Fear was mentioned across included articles as a stigma driver. Other reported stigma drivers identified included feelings of discrimination, isolation, danger, lack of support, shame, and stress. Poor infection control (IC) was the leading stigma facilitator. Other stigma facilitators identified were differing IC interpretations, workforce culture, and workplace inequality facilitating to stigmatization of HCWs. Three key recommendations identified were addressing infection control issues; increase the competence of healthcare workers; and provide psychosocial assistance, emphasizing HCW safety during DRTB activities. DRTB stigma among HCWs is multifaceted, largely driven by fear and facilitated by varying implementation or interpretations of policies within the workplace. Making HCWs feel safe while conducting DRTB activities is a priority issue that should be addressed by improving IC, training and psychosocial support. More studies investigating country-specific and multilevel DRTB-related stigma among HCWs are required to inform the development of an effective stigma intervention strategy.

Prevalence and risk factors of workplace violence against healthcare workers in Bangladesh and its consequences: A nationwide cross-sectional study

BackgroundWorkplace violence (WPV) is a global concern that poses major threats to healthcare professionals. Understanding the prevalence, risk factors, and consequences of WPV is key to developing effective preventive measures to ensure the safety of healthcare workers. ObjectivesThis study aimed to assess the weighted prevalence, risk factors, and consequences of WPV among healthcare professionals in Bangladesh. MethodsA cross-sectional study was conducted from May 9, 2022, to April 3, 2023. A total of 3977 healthcare professionals from various healthcare settings participated through a convenience sampling technique. A structured questionnaire was used to collect data in three phases. Statistical analyses included descriptive statistics, Fisher's exact tests, and multinomial logistic regression. ResultsThe study revealed that 77.29% of healthcare professionals (n = 3074) reported experiencing WPV. Verbal abuse/threat (28.74%), emotional violence (20.9%), physical violence (17.53%), and sexual harassment (17.85%) were the most prevalent types of violence reported. WPV incidents primarily occurred at patients' bedside (27.31%) and in nursing/doctor stations (24.84%). The night shift had the highest prevalence of violence (35.66%). Patient relatives/friends (43.55%) and visitors (31.38%) were the primary perpetrators. The major factors associated with WPV included lack of organizational policy (11.32%), long waiting (11.16%), medical error (9.71%), and poor patient management systems (9.53%). Consequences of physical WPV included head injuries (23.69%), ocular injuries (27.21%), fractures (14.99%), and unconsciousness (17.05%). ConclusionsThis study highlights the alarming prevalence of workplace violence among healthcare professionals in Bangladesh and identified major risk factors to the occurrence of violence. Urgent attention from policymakers and healthcare organizations is required to develop and implement preventive measures targeting these risk factors. Strengthening security systems, establishing workplace violence policies, and providing training programs are essential to ensure a safer environment for healthcare workers. It is imperative to increase awareness of workplace violence laws and their enforcement to effectively address this pressing issue and safeguard the well-being of healthcare professionals in Bangladesh.

Effective Anti-Fogging Agent for Glasses and Face Shields in the Treatment of Ebola in Uganda: Implications for Healthcare Worker Safety and Patient Care

Evidence on the effective Antifogging Agents (AFA) for use during Donning of goggles and face shields in Ebola Treatment Centres (ETC) is lacking. This study aimed at establishing an effective antifogging agent, the side effects of fogging, and the impact of fogging. It was a cross-sectional study conducted from 26 September to 08 October 2022 in Fort Portal Regional Referral Hospital Ebola Treatment Centre in which 21 Health Care Workers (HCWs) managing Ebola patients were recruited. All were healthy no signs or symptoms. AFA used were Liquid Soap & Alcohol 80%. The Control was Standard of Care. As they donned goggles the time taken to fog was noted, side effects and impact were all noted for each HCW after they had doffed off their Personal Protective Equipment (PPE). AFA was significant if P < 0.05 with a 95% Confidence Interval. Study findings; 66.7% of those that used liquid soap never fogged after 4 hours in PPE with p <0.001, The participants who used Alcohol all fogged 30 minutes after donning with p=0.030, and on the standard of care all of them fogged within 21 minutes of donning PPE with p=0.552. In this study over 90% who fogged could not see and stopped working. Of those who fogged 43 % developed dizziness and 53% developed headache. This study has demonstrated liquid soap is a superior AFA and thus increased the time the health care workers spend attending to critically ill Ebola patients and it reduces chances of infection among health care workers resulting from fogging of goggles. This study recommends WHO and MoH to include in their IPC guidelines the use of liquid soap as an antifogging agent for the goggles and face shields during donning in order to improve the level of care in the Isolation Treatment Centres.

GLOVES: DOS AND DON’TS

Standard infection-prevention and control procedures must be in place during all healthcare contacts, regardless of whether a patient is known to be contagious or not, to stop the transmission of infection. As with all the items of personal protective equipment, the need for gloves must be subject to careful risk assessment of the task to be carried. Having decided that gloves should be used, a choice between sterile and non-sterile gloves must be made depending on the tasks undertaken.
 Sterile gloves are worn to prevent the transmission of microorganisms from healthcare workers (HCWs) to patients. In addition, they also protect against blood and body fluids during surgical and aseptic procedures. The recommendation to wear sterile gloves includes all surgical interventions, vaginal delivery, Insertion of indwelling devices (IV line, urinary catheter, etc.), performing lumber punctures, giving epidurals, etc., invasive radiological procedures, preparing total parenteral nutrition and chemotherapeutic agents (1). 
 Non-sterile gloves are used to protect the HCWs from acquiring microorganisms from patients and contaminated environments, coming in direct contact with blood and body fluids by contact with non-intact skin or mucous membranes, e.g., vaginal examination, oral/dental care, emptying urine bags, suctioning of endotracheal tubes and by contact with the potential presence of infectious agents, e.g., MRSA both on intact and non-intact skin. Non-sterile gloves are also to be worn by contacting blood and body fluids indirectly by handling and cleaning contaminated items and equipment, handling clinical waste, and cleaning up spills of blood and body fluids (1).
 However, misuse and carelessness while wearing gloves can lead to cross-contamination, and infection spread rather than infection prevention and control. Possible microbial transmission has been documented where used gloves were not removed or changed before performing care activities requiring asepsis, not changing gloves while moving from one patient to the other, taking care of multiple patients with the same pair of gloves, wearing layers of gloves and then removing the outer layer as they move from room to room (2).
 Failure to change or remove contaminated gloves is also a significant cause of poor compliance with hand hygiene, creating a high risk of microbial transmission. Gloves are never meant to be worn in lieu of hand hygiene. Healthcare workers should wash their bare hands according to the World Health Organization's five moments of hand hygiene (3) Hand hygiene has to be followed strictly before donning and after the doffing of gloves. Gloves should only be worn in cases of the indications listed above. In some areas, HCWs are usually seen wearing gloves when there is no need. Besides contact precautions, gloves are not recommended while taking vitals, injecting intramuscularly and subcutaneously, giving oral medicines, vascular line manipulation in the absence of blood leakage, using the telephone, writing in patients’ charts, and moving patients’ furniture. Gloves should never be worn in the hallways or elevators, moving from one place to another within the hospital premises, or serving multiple patients. Gloves are not meant to be worn over and over or washed in between usage (4).
 Adhering to hand hygiene and rationalizing the use and type of gloves in any healthcare setting can help prevent microbial contamination of the environment and for the safety of patients and HCWs from microorganisms.

December 2022-Printed Issue

The December 2022 issue of Patient Safety is available to read and download at no charge. Our latest publication offers vital information, tools, resources, and articles that can help improve the safety and well-being of patients and healthcare workers in the new year. • Taylor et al. describea patient safety initiative that reduced the incidence of perioperative emergence delirium at a Veterans Affairs hospital (https://patientsafetyj.com/index.php/patientsaf/article/view/emergence-delirium)—and provide you with everything you need to replicate their work. • What is the past, present, and future of nursing? Nursing professor Eileen Fruchtl discusses how nursing education has been evolving and what it may become (https://patientsafetyj.com/index.php/patientsaf/article/view/nursing-education) following the pandemic, and Toothaker et al. look at the challenges recently graduated nurses face as they transition into the workforce (https://patientsafetyj.com/index.php/patientsaf/article/view/nurse-transition). • John Olsen et al. describe the success and impact of Jefferson Health’s peer support program, RISE (https://patientsafetyj.com/index.php/patientsaf/article/view/Jefferson-rise) (Resilience in Stressful Events). • Abigail Baluyot et al. share communication problems they identified in patient hand-offs between hospitals and skilled nursing facilities (https://patientsafetyj.com/index.php/patientsaf/article/view/hospital-snf-communication), and what they did to improve the process. This issue also includes an important safety alert about the risk of air embolism during cardiac ablation procedures (https://patientsafetyj.com/index.php/patientsaf/article/view/air-embolism), an update to acute care reporting rates in Pennsylvania last year (https://patientsafetyj.com/index.php/patientsaf/article/view/2021-data-update), and an inside look at how prison systems in Pennsylvania deliver healthcare to inmates (how%20prison%20systems%20in%20Pennsylvania%20deliver%20healthcare%20to%20inmates). Patient Safety is fully open access (no fees for authors or readers). We welcome submissions from all over the world. If your work can help advance patient safety, please submit it to us for consideration (https://patientsafetyj.com/for-authors), and kindly share our journal with friends, family, colleagues, and caregivers.

Patient Safety Culture: The Impact on Workplace Violence and Health Worker Burnout.

Patient and health care worker safety is an interconnected phenomenon. To date, few studies have examined the relationship between patient and worker safety, specifically with respect to work safety culture. Therefore, we examined patient safety culture, workplace violence (WPV), and burnout in health care workers to identify whether patient safety culture factors influence worker burnout and WPV. This cross-sectional study used secondary survey data sent to approximately 7,100 health care workers at a large academic medical center in the United States. Instruments included the Hospital Survey on Patient Safety Culture, a WPV scale measuring physical and verbal violence perpetrated by patients or visitors, and the Emotional Exhaustion scale from the Maslach Burnout Inventory. These analyses included 3,312 (47%) hospital staff who directly interacted with patients. Over half of nurse (62%), physician (53%), and allied health professional respondents (52%) reported experiencing verbal violence from a patient, and 39% of nurses and 14% of physicians reported experiencing physical violence from a patient. Burnout levels for nurses (2.67 ± 1.02) and physicians (2.65 ± 0.93) were higher than the overall average for all staff (2.61 ± 1.0). Higher levels of worker-reported patient safety culture were associated with lower odds of WPV (0.47) and lower burnout scores among workers (B = -1.02). Teamwork across units, handoffs, and transitions were dimensions of patient safety culture that also influenced WPV and burnout. Our findings suggest that improvements in hospital strategies aimed at patient safety culture, including team cohesion with handoffs and transitions, could positively influence a reduction in WPV and burnout among health care workers.

Support for healthcare workers and patients after medical error through mutual healing: another step towards patient safety

BackgroundMedical errors, especially those resulting in patient harm, have a negative psychological impact on patients and healthcare workers (HCWs). Healing may be promoted if both parties are able to work...

Seroprevalence of Anti-SARS-CoV-2 IgG Antibody in Healthcare Workers: A Report From Rafsanjan City

Background: Healthcare workers (HCWs) have a high risk of catching SARS-CoV-2 infection. Seroprevalence studies can provide related data on HCWs with a history of infections. Despite numerous seroepidemiological reports of COVID-19 in different groups, there are no such reports for HCWs working in Rafsanjan City, Iran. This study aimed to determine the SARS-CoV-2 seroprevalence among HCWs. Methods: Blood samples were obtained from 295 participants, including healthcare personnel and administrative staff. The SARS-CoV-2 IgG antibody was measured by the ELISA method, and the obtained data were analyzed with the Chi-square test and logistic regression. A P<0.05 was considered statistically significant. Results: The previous exposure to COVID-19 was higher in HCWs than in administrative department staff. Fifteen out of 130 (11.5%) participants had experienced SARS-CoV-2 infection without any symptoms. The results of logistic regression indicated that traveling (OR: 018, 95% CI: 0.08–0.74, P=0.001), occupation (OR: 0.2, 95% CI: 0.01–0.94, P<0.05), history of respiratory problems (OR: 0.15, 95% CI: 0.01–1.94, P<0.05), and major clinical signs (OR: 8.09, 95% CI: 3.7-17.66, P<0.001) are important factors which affect SARS-CoV-2 IgG antibodies. Conclusion: Our results indicated an occupational risk for SARS-CoV-2 infection among HCWs. Because some HCWs are asymptomatic, their communication, such as traveling, must be controlled, and it is necessary to ensure the safety of HCWs and reduce their transfer to the community and patients.

Sleep and Safety among Healthcare Workers: The Effect of Obstructive Sleep Apnea and Sleep Deprivation on Safety.

Almost one billion people worldwide are affected by Obstructive Sleep Apnea (OSA). Affected individuals experience disordered breathing patterns during sleep, which results in fatigue, daytime drowsiness, and/or sleep deprivation. Working under the influence of these symptoms significantly impairs work productivity and leads to occupational accidents and errors. This impact is seen in healthcare workers (HCWs) who are not immune to these conditions. However, poorly controlled OSA in this subset of individuals takes a heavy toll on patient care due to the increased risk of medical errors and can also alter the mental and physical well-being of the affected HCW in various ways. OSA and safety issues have been recognized and mitigated among the airline and transport industries; however, the healthcare industry lags in addressing these concerns. This article reviews hypersomnolence and sleep disorder as key clinical features of OSA and their effect on HCW safety.

Influence of Psychological Factors on Vaccination Acceptance among Health Care Workers in Slovenia in Three Different Phases of the COVID-19 Pandemic.

COVID-19 vaccination acceptance among healthcare workers (HCWs) is very important to control the pandemic and to ensure the safety of HCWs and patients. As psychological factors may affect the decision to be vaccinated, the aim of this study was to investigate the influence of psychological factors on vaccination acceptance in different phases of the COVID-19 pandemic. A cross-sectional study using a web-based survey was conducted among HCWs in Slovenia at the beginning of the pandemic (N = 851), one month later (N = 86), and one year later (N = 145) when vaccines were already available. The results showed that the influence of psychological factors (anxiety, psychological burden, perceived infectability, and germ aversion) was specific for each survey period. At the beginning of the pandemic, vaccination intention was positively associated with anxiety. In the third survey period, anxiety was not exposed as a predictive factor for vaccination intention. However, comparison of vaccination status among groups with different levels of anxiety revealed an interesting distinction within those in favour of vaccination; in the group with minimal levels of anxiety, there was a relatively high share of respondents that were already vaccinated, whereas in the group with severe anxiety, most individuals intended to be vaccinated but hesitated to take action.

Identification and reduction of hazardous drug surface contamination through the use of a novel closed-system transfer device coupled with a point-of-care hazardous drug detection system.

Minimizing hazardous drug (HD) contamination is critical for protecting the health of healthcare workers (HCWs) and patients. Alarmingly, widespread HD contamination has been documented across a variety of clinical settings. Quantitative wipe sampling presents significant time and cost barriers, resulting in routine monitoring adherence rates around 25%. Closed-system drug transfer devices (CSTDs) and qualitative point-of-care tests can be implemented to overcome these barriers. In this study, we tested the effects of the BD PhaSeal Optima (Becton, Dickinson and Company), a recently introduced CSTD, on HD contamination at 2 chemotherapy infusion centers. Wipe samples were taken at 29 workstations at each location prior to and a year following CSTD implementation. Additionally, traditional liquid chromatography with mass spectrometry (LCMS/MS) analyses were compared against a novel lateral flow immunoassay HD testing device (BD HD Check; Becton, Dickinson and Company) to determine the validity of the qualitative assay. We found a 46% reduction in HD contamination after incorporating the CSTD into clinical workflows. Across time points and sites, HD contamination reported by the BD HD Check device was 91% accurate against LCMS/MS and 98% accurate within its limits of detection. Collectively, the evaluated CSTD and lateral flow immunoassay device may help to reduce HD contamination and provide real-time measures of contamination, respectively. As part of a multifaceted approach, these devices may help minimize barriers to routine monitoring, ultimately improving the safety of HCWs and patients.

Hospitals of the Future: Designing Interactive Robotic Systems for Resilient Emergency Departments

The Emergency Department (ED) is a stressful, safety-critical environment, which is often overcrowded, noisy, chaotic, and understaffed. The built environment plays a key role in patient outcomes, experiences, and the mental health of healthcare workers (HCWs). However, once a space is built, it is difficult to change it; so the modularity and adaptability of new technologies such as robots could potentially help stakeholders mitigate some of these challenges; yet, there is a lack of research in this area, particularly in the ED. In this paper, we address this gap by engaging HCWs in a research-through-design process, utilizing design fiction, to envision a future resilient ED. Here, robots scurry along the ceiling, provide help at the bedside, and smart furniture and walls provide spaces for privacy and calm. We co-created design prototypes of future intelligent systems that can modify the built environment to support resilience, which we then used to co-create a Design Catalog with HCWs, which contains a collection of future technology prototypes contextualized within the ED. We found that HCWs envisioned many ways for intelligent systems to help them reimagine the built environment, including ways to enhance HCW-patient communication, improve patient experience, support both HCW and patient safety, and use reconfigurable spaces to support privacy. We hope our work inspires further exploration into using new technologies to reimagine and reconfigure the built environment to support resilient hospitals.