Measures In Healthcare Workers Research Articles

MOLECULAR DIAGNOSTIC LABORATORY SETUP AND MAINTENANCE FOR SARS-COV-2

Abstract
 Aim: Importance of laboratory diagnosis has come to the spotlight once again with the Covid-19 pandemic caused by Sars-CoV-2 and significant changes have taken place in terms of laboratory operation. A global effort has emerged when all healthcare professionals faced a biological threat. Interlaboratory collaboration and multidisciplinary approach contributed to this effort. This study aims to explain step-by-step establishment of a fully capable laboratory for Sars-CoV-2 diagnosis to support local and global fight for the COVID-19 pandemic.
 Methods: Several precautions were taken, and disaster plans were updated because of the changes in employee health and workload distribution. Some of these are setting up a laboratory from scratch for microorganism diagnostic tests performed in pandemic cases, measures for healthcare workers, personnel assignment planning, changes in the variety and number of tests, innovations in quality standards and the contribution of laboratories to scientific studies.
 Results: XXXXX Molecular Diagnostic Laboratory has become one of the laboratories in Türkiye where Sars-Cov-2 and its mutations have been studied the most with 1,710,856 samples between 01 October 2020 and 01 May 2022 since its establishment and it has become the laboratory with the highest number of equipment and technical personnel in the capital.
 Conclusion: This study summarizes all the phases of XXXXX Molecular Diagnostic Laboratory beginning with its establishment from the scratch and covers all the steps to render this facility fully operational.
 
 Keywords: COVID-19, laboratory disaster planning, laboratory staff, personal protective equipment, Sars-CoV-2

Evaluation of the knowledge of sun exposure and sun protective measures in healthcare workers

Introduction: Solar ultraviolet (UV) radiation has a great impact on human life. The sun has always played an important role in Asian culture, so much so, that it is often prayed to as a God. Prolonged sun exposure can cause extensive and chronic harmful effects. Healthcare personnel is supposed to have good knowledge regarding sun protection as they play a key role in society disseminating knowledge to the general public. There are limited data regarding the knowledge of sun protection and sunscreen practice among health care workers. Methods: This descriptive cross-sectional study was carried out from June to October 2020 on healthcare workers (medical staff) in Kathmandu Medical College Teaching Hospital. A questionnaire was distributed to the target study population without disturbing or hampering the healthcare worker’s duty. Results: Out of a total of 264 participants in the study, 84 (31.8%) were male and 180 (68.2%) were female. The knowledge of proper terminology for SPF (Sun Protection Factor) was noted in 196 (74.2%) and 57 (21.6%) agreed that the value of SPF was related to age. No significant difference was noted regarding knowledge about the time of sun exposure for Vitamin D synthesis. No significant differences were found in practices of sunscreen use for purposes of fairness, or prevention of tanning, wrinkle, mole, and skin cancer. Conclusion: A higher level of education was associated with better knowledge and proper abiding practices regarding sunscreen use. As healthcare workers play a key role in distributing information in society, they should be targeted in education campaigns regarding sun exposure and sun protection measures; with these efforts focused more on nurses and medical officers.

Assessment of hand hygiene strategies on skin barrier function during COVID-19 pandemic: A randomized clinical trial.

Coronavirus disease 2019 (COVID-19) has increased the frequency of handwashing. There is scarce evidence regarding the impact of different hand hygiene procedures on skin barrier function in clinical practice. To compare the impact on skin barrier function of different hand hygiene measures in healthcare workers in daily practice. A randomized controlled clinical trial was conducted. Participants were randomized to sanitize their hands with water and soap, alcohol-based hand sanitizers (ABHSs), or disinfectant wipes during their 8-hour working shift. Epidermal barrier functional parameters, such as transepidermal water loss (TEWL), and the microbial load were assessed before and immediately after the working day. Tolerance and acceptability of each product were recorded after work. Sixty-two participants were included and 20, 21, and 21 were randomized to use water and soap, ABHS, and disinfectant wipes, respectively. After the 8-hour shift, TEWL increase was higher with disinfectant wipes than with soaps or ABHS (+5.45 vs +3.87 vs -1.46 g h-1 m-2 , respectively; P=.023). Bacteria and fungi colony-forming unit (CFU) count reductions were lower for the water and soap group than for ABHS and disinfectant wipes. Disinfectant wipes were considered more difficult to use (P=.013) compared with water and soap and ABHS. Daily hand hygiene with ABHS showed the lowest rates of skin barrier disruption and the highest reduction of CFU.

Sarampo: protocolo de atuação num Hospital Português

Introduction Measles is a highly contagious infectious disease caused by a paramyxovirus. In the last six decades, the promotion of vaccination against this disease has drastically reduced its incidence. Despite this, in 2016, around seven million new infections were diagnosed. Since healthcare workers have an increased risk of infection, the promotion of vaccination by the Occupational Health Services represents one of the main strategies to consolidate the eradication of this pathology in Portugal. Objectives Review the clinical aspects and prevention measures of Measles with a focus on vaccination and present post-exposure prophylaxis measures for healthcare workers in a Portuguese hospital. Methodology It was performed a literature search about the clinical and preventive aspects of Measles using the main guidelines of organizations, such as the Direção-Geral da Saúde and Centers for Disease Control and Prevention, and through identification of scientific articles on PubMed/MEDLINE databases. Results/Discussion This infection has an incubation period that can last between seven to twenty-one days, and it’s followed by the prodromal, exanthematic, and recovery phases. Infected patients are contagious four days before and four days after the rash appears. The diagnosis is based on clinical, laboratory and epidemiological criteria. A confirmed case of Measles must meet clinical and laboratory criteria. The treatment is based on supportive care, to prevent dehydration. Vaccination is the best preventive measure against this disease. All healthcare workers without a credible history of Measles should have two vaccine doses. In an outbreak context, exposed workers must be identified and the Occupational Health Departments must apply appropriate post-exposure prophylaxis measures, as well as define which employees require work avoidance and for how long. Conclusion The existence of well-defined action plans for healthcare workers who had contact with infected patients is essential to minimize the occurrence of intra-hospital transmission chains and the subsequent infection of people at higher risk of complications from the disease. The presented protocol allows acting clearly and concisely when dealing with a suspected or confirmed Measles case and its contacts and provides a succinct review of the clinical, therapeutic and preventive data of this pathology. Keywords: Measles; Measles vaccine; Vaccination; Outbreak; Prevention; Occupational Health.

Capacity development and safety measures for health care workers exposed to COVID-19 in Bangladesh

BackgroundThe safety of health care workers (HCWs) in Bangladesh and the factors associated with getting COVID-19 have been infrequently studied. The aim of this study was to address this gap by assessing the capacity development and safety measures of HCWs in Bangladesh who have been exposed to COVID-19 and by identifying the factors associated with respondents’ self-reported participation in capacity development trainings and their safety practices.MethodsThis cross-sectional study was based on an online survey of 811 HCWs working at 39 dedicated COVID-19 hospitals in Bangladesh. A pretested structured questionnaire consisting of questions related to respondents’ characteristics, capacity development trainings and safety measures was administered. Binary logistic regressions were run to assess the association between explanatory and dependent variables.ResultsAmong the respondents, 58.1% had been engaged for at least 2 months in COVID-19 care, with 56.5% of them attending capacity development training on the use of personal protective equipment (PPE), 44.1% attending training on hand hygiene, and 35% attending training on respiratory hygiene and cough etiquette. Only 18.1% reported having read COVID-19-related guidelines. Approximately 50% of the respondents claimed that there was an inadequate supply of PPE for hospitals and HCWs. Almost 60% of the respondents feared a high possibility of becoming COVID-19-positive. Compared to physicians, support staff [odds ratio (OR) 4.37, 95% confidence interval (CI) 2.25–8.51] and medical technologists (OR 8.77, 95% CI 3.14–24.47) were more exhausted from working in COVID-19 care. Respondents with longer duty rosters were more exhausted, and those who were still receiving infection prevention and control (IPC) trainings were less exhausted (OR 0.54, 95% CI 0.34–0.86). Those who read COVID-19 guidelines perceived a lower risk of being infected by COVID-19 (OR 0.44, 95% CI 0.29–0.67). Compared to the respondents who strongly agreed that hospitals had a sufficient supply of PPE, others who disagreed (OR 2.68, 95% CI 1.31–5.51) and strongly disagreed (OR 5.05, 95% CI 2.15–11.89) had a higher apprehension of infection by COVID-19.ConclusionThe findings indicated a need for necessary support, including continuous training, a reasonable duty roster, timely diagnosis of patients, and an adequate supply of quality PPE.

In-depth profiling of COVID-19 risk factors and preventive measures in healthcare workers

PurposeTo determine risk factors for coronavirus disease 2019 (COVID-19) in healthcare workers (HCWs), characterize symptoms, and evaluate preventive measures against SARS-CoV-2 spread in hospitals.MethodsIn a cross-sectional study conducted between May 27 and August 12, 2020, after the first wave of the COVID-19 pandemic, we obtained serological, epidemiological, occupational as well as COVID-19-related data at a quaternary care, multicenter hospital in Munich, Germany.Results7554 HCWs participated, 2.2% of whom tested positive for anti-SARS-CoV-2 antibodies. Multivariate analysis revealed increased COVID-19 risk for nurses (3.1% seropositivity, 95% CI 2.5–3.9%, p = 0.012), staff working on COVID-19 units (4.6% seropositivity, 95% CI 3.2–6.5%, p = 0.032), males (2.4% seropositivity, 95% CI 1.8–3.2%, p = 0.019), and HCWs reporting high-risk exposures to infected patients (5.5% seropositivity, 95% CI 4.0–7.5%, p = 0.0022) or outside of work (12.0% seropositivity, 95% CI 8.0–17.4%, p < 0.0001). Smoking was a protective factor (1.1% seropositivity, 95% CI 0.7–1.8% p = 0.00018) and the symptom taste disorder was strongly associated with COVID-19 (29.8% seropositivity, 95% CI 24.3–35.8%, p < 0.0001). An unbiased decision tree identified subgroups with different risk profiles. Working from home as a preventive measure did not protect against SARS-CoV-2 infection. A PCR-testing strategy focused on symptoms and high-risk exposures detected all larger COVID-19 outbreaks.ConclusionAwareness of the identified COVID-19 risk factors and successful surveillance strategies are key to protecting HCWs against SARS-CoV-2, especially in settings with limited vaccination capacities or reduced vaccine efficacy.

Development of a web-based contact tracing and point-of-care-testing workflow for SARS-CoV-2 at a German University Hospital

IntroductionIn late 2019, a novel coronavirus was detected in China. Supported by its respiratory transmissibility, even by people infected without symptomatic disease, this coronavirus soon began to rapidly spread worldwide.BackgroundMany countries have implemented different infection control and containment strategies due to ongoing community transmission. In this context, contact tracing as well as adequate testing and consequent quarantining of high-risk contacts play leading roles in containing the virus by interrupting infection chains. This approach is especially important in the hospital setting where contacts often cannot be avoided and physical distance is usually not possible. Furthermore, health care workers (HCWs) usually have contact with a variety of vulnerable people, making it essential to identify infections among hospital employees as soon as possible to interrupt the rapid spread of SARS-CoV-2 in the facility. Several electronic tools for contact tracing, such as specific software or mobile phone apps, are available for the public health sector. In contrast, contact tracing in hospitals often has to be carried out without helpful electronic tools, and an enormous amount of human resources is typically required.AimFor rapid contact tracing and effective infection control and management measures for HCWs in hospitals, adapted technical solutions are needed.MethodsIn this study, we report the development of our containment strategy to a web-based contact tracing and rapid point-of-care-testing workflow.Results/conclusionOur workflow yielded efficient control of the rapidly evolving situation during the SARS-CoV-2 pandemic from May 2020 until January 2021 at a German University Hospital.

Rapid decline of neutralizing antibodies against SARS-CoV-2 among infected healthcare workers

There are only few data concerning persistence of neutralizing antibodies (NAbs) among SARS-CoV-2-infected healthcare workers (HCW). These individuals are particularly exposed to SARS-CoV-2 infection and at potential risk of reinfection. We followed 26 HCW with mild COVID-19 three weeks (D21), two months (M2) and three months (M3) after the onset of symptoms. All the HCW had anti-receptor binding domain (RBD) IgA at D21, decreasing to 38.5% at M3 (p < 0.0001). Concomitantly a significant decrease in NAb titers was observed between D21 and M2 (p = 0.03) and between D21 and M3 (p < 0.0001). Here, we report that SARS-CoV-2 can elicit a NAb response correlated with anti-RBD antibody levels. However, this neutralizing activity declines, and may even be lost, in association with a decrease in systemic IgA antibody levels, from two months after disease onset. This short-lasting humoral protection supports strong recommendations to maintain infection prevention and control measures in HCW, and suggests that periodic boosts of SARS-CoV-2 vaccination may be required.

Emerging issues and preventive measures for health care workers in the diagnostic field in coronavirus disease 2019 pandemic

Coronavirus disease 2019 caused by severe acute respiratory syndrome-CoV-2 is an emerging infectious disease first identified in Wuhan City, Hubei Province, China, which subsequently spread as a global pandemic posing a global threat. As per World Health Organisation worldwide around 38 lac people have been infected and 2.6 lac people have died from the disease and in India 59,662 people are infected with 1981 deaths by May 9, 2020. It is feasible that potentially infectious specimens may be submitted in our laboratory those are the impending source of infection to the laboratory personnel. Using imaging equipment on coronavirus confirmed/suspected patient/carriers is a serious hazard for healthcare providers because there is a risk that the virus could remain on the surface of the computed tomography scan machines or ultrasound (US) probes/patient bed/couch. Here, we have enlisted the rigorous biosafety measures which if executed appropriately can significantly drop the chances of spread of infection to health care workers in these diagnostic sections.

Knowledge, Attitudes and Practice Survey among Health-Care Workers in Times of COVID-19 Pandemic: Identifying Gaps to Strengthen Infection Control Program for Future Outbreaks.

Sir, Coronavirus disease 2019 (COVID 19), an emerging viral respiratory illness, has become a pandemic. Further, COVID 19 infection among health-care workers (HCWs) has become a huge threat. HCWs are at the frontline of any outbreak response and are at great risk of acquiring the infection. We have already seen the morbidity and mortality of this highly infectious disease suffered by the HCW in different countries. For HCW, the psychological effects of such exposure can jeopardize the medical care they provide. WHO and CDC have also given recommendations for preventing infection to HCW.[12] Suboptimal adherence to infection control measures among HCWs is one of the major risk factors for acquiring the infection.[3] Adherence to these measures in HCWs is largely influenced by their knowledge, attitudes, and practice (KAP) concerning COVID 19. An online cross-sectional survey was done among HCWs, including physicians, nurses, and technicians working in various hospitals in India with the aim to identify gaps in knowledge, attitude, and practices. A self-administered, pre-tested questionnaire consisting of 30 questions on demographic characteristics, sources of COVID information and knowledge, attitude and practices and an open-ended question regarding COVID was designed and, after a pilot study, sent to different participants as a Google survey form. Among the 546 respondents, poor knowledge was apparent in 12.1% of respondents regarding the disposal of the dead body of COVID-19 patient, screening tests and oxygen therapy. However, participants had good knowledge regarding hand hygiene, personal protective equipment (PPE), and the use of masks and surface disinfection. About 97.8% of respondents agreed that it is important to participate in infection control programs, and majority agreed that proper use of PPE can prevent infection. Regarding practices, only 46.2% made standard operating protocols regarding for their departments. In the last open-ended question regarding suggestions for future, valuable inputs like patient relative education, telemedicine, visitor policy, changing the teaching pattern of medical students, and strengthening public health laboratories at district levels for diagnosis of emerging diseases was obtained. After getting the responses, a PPT document was mailed to respondents with information regarding this disease, which would probably enhance their knowledge and help practicing guidelines related to this disease. A study has already highlighted insufficient knowledge of HCWs toward COVID 19.[4] All countries have made substantial efforts to train HCWs on infection control measures against COVID19. The success of these training programs can be measured by doing KAP analysis of healthcare workers. Generating such data at this critical point will help in identifying gaps and strengthening training programs. However, KAP surveys should be conducted at regular intervals. Tailored, periodic infection prevention and control training in healthcare facilities based on these survey results will improve the infection control practices. Apart from continuing education, newer interventions for improving the gaps in practices should be explored. More of reinforcement tools should be designed to effect long-lasting changes. Thus more studies are required to highlight the unreached gaps in knowledge, attitude, and practice of healthcare workers with the aim to reduce the risk of infection among HCWs and preparing institutes for future outbreaks. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

ОЦЕНКА МЕР СОЦИАЛЬНОЙ ПОДДЕРЖКИ МЕДИЦИНСКИХ РАБОТНИКОВ ИРКУТСКОЙ ОБЛАСТИ, ЗАЯВЛЕННЫХ В ОФИЦИАЛЬНЫХ ПРЕДЛОЖЕНИЯХ ОБ ИХ ТРУДОУСТРОЙСТВЕ

Significance. Social support measures for healthcare workers are one of the key mechanisms for retaining specialists. Meanwhile, according to the Ministry of Health of the Russian Federation, the current indicators of their implementation remain unsatisfactory. The purpose of the study was to assess frequency and structure of social support measures for medical workers based on the data of the official employment proposals posted by state medical organizations on the website of the Ministry of Health of the Irkutsk Region. Material and methods. Statistical charts have been developed, they included information from the employment proposals posted on the official website of the Ministry of Health of the Irkutsk Region, the total number of proposals added up to 429. Statistical methods to process the material included calculation of the extensive and intensive indexes without determining confidence intervals because the general aggregate was used in all cases. Results. The most wanted out of all doctors are district therapists (7.0% in the structure of doctors’ vacancies), followed by obstetricians-gynecologists (6.7%) and infectious disease specialists (6.1%). As for nursing staff, the highest number of employment proposals were looking for feldshers (22.4%), ward nurses (12.9%) and district nurses (11.2%). Of the total number of job proposals, social support measures were stated in 76.2 proposals out of 100, while the frequency of these measures added up to 77.4 out of 100 for doctors and 63.8 for nurses. The stated social support measures for doctors in the ascending order include as follows: issues related to housing (79.2 per 100 employment proposals); direct financial support (72.2 per 100); provision of a place in a preschool facility without waiting (35.1); additional vacation and travel expense reimbursement (27.2); reimbursement of expenses related to relocation and travel to the place of employment (14.4); payment for postgraduate and additional professional education (9.3). The rank structure of social support measures for nursing staff differs in the order, starting from the third. Conclusion. In both absolute and relative terms, the measures of social support stated by the employment proposals for doctors prevail. While primary health care workers are in highest demand, the need for such specialists is not directly reflected by the corresponding frequency of the stated social support measures. The results obtained are relevant to the development and implementation of the evidence-based personnel policy in healthcare at the level of an individual region of the Russian Federation.

Peculiarities of care for patients with coronavirus infection. Important safety issues for health care workers

Background. In case of coronavirus disease (COVID-19), contact persons include, but are not limited to, health care workers (HCW) and caregivers of COVID-19 patients. Personal protective equipment is required for HCW working with patients or individuals with suspected COVID-19. Correct sequence and the correct technique of putting them on is very important.&#x0D; Objective. To describe the safety measures for HCW in care of patients with COVID-19.&#x0D; Materials and methods. Analysis of literature sources on this topic.&#x0D; Results and discussion. Contaminated environmental surfaces take part in the contact route of transmission. To reduce the role of fomites in the transmission of the new SARS-CoV-2 coronavirus, special recommendations of the Ministry of Health on surface cleaning and disinfection have been developed. After cleaning, disinfectants must be used to reduce the viral load on the surface. These disinfectants are also effective against other pathogens that are important in health care settings. Such agents include ethanol 70-90 %, chlorine-based agents, and hydrogen peroxide &gt;0.5 %. The register of disinfectants of Ukraine contains more than 200 brands. The vast majority of them are represented by alcohol- and chlorine-containing solutions of various concentrations, colors and odors. The use of these solutions is limited to the torso and extremities. These solutions have a number of limitations and caveats in their use. For instance, in case of contact with mucous membranes, they have an irritating effect and require rinsing with plenty of water. Vapors of some of them should not be inhaled, so they should be used in well-ventilated areas or with protective equipment. Alcohol-based products should not be applied to damaged areas of the skin due to protein denaturation. The Food and Drug Administration (FDA) recommends to use the chlorine- and alcohol-based solutions with caution due to the lack of evidence of their safety. The decamethoxine-based solution Yusept (“Yuria-Pharm”) is intended for disinfection of hands and other parts of the body, including the face; for disinfection of HCW gloves and gloves in other places; for disinfection and pre-sterilization cleaning of all medical devices from various materials; for disinfection of hairdresser’s, manicure, pedicure and cosmetic accessories; for disinfection of rooms, furniture, patient care items, hygiene products, utensils, containers, sanitary equipment, rubber carpets; for current, final and preventive disinfection; for use in aerosol disinfection systems such as Yu-box and other disinfection systems. Proper hand washing technique is also an important preventive measure. The effectiveness of prevention of HCW infection during their professional duties depends on how serious the problem is taken by the management of the health care institution and the HCW, who work with infectious patients, themselves.&#x0D; Conclusions. 1. For HCW working with patients or persons with suspected COVID-19, the use of personal protective equipment is mandatory. 2. Contaminated surfaces take part in the implementation of the contact route of infections’ transmission. 3. The vast majority of disinfectant solutions are alcohol- and chlorine-containing ones, which have a number of limitations and precautions in use. 4. Yusept solution is intended for disinfection of hands and other parts of the body, including the face; for disinfection and pre-sterilization cleaning of all medical devices; for disinfection of rooms, furniture, patient care items; for use in aerosol disinfection systems.

Aerosolization in Endoscopic Sinus Surgery and Risk Mitigation in the COVID-19 Era: A Scoping Review.

Objective The continually evolving coronavirus disease 2019 (COVID-19) pandemic has created a dire need for rapid reorganization of health care delivery within surgical services. Ensuing initial reports of high infection rates following endoscopic sinus and skull base surgery, various expert and societal guidelines have emerged. We hereby provide a scoping review of the available literature on endoscopic sinus and skull base surgery, exploring both the risk of aerosolization and expert recommendations on surgical management during the pandemic. Methods A literature search of the PubMed database was performed up until May 9th, 2020. Additionally, websites and published statements from otolaryngology associations were searched for recommendations. This scoping review followed the guidelines provided by the Preferred Reporting Items for Systematic Reviews and Meta Analyses Extension for Scoping Reviews. Results A total of 29 peer-reviewed publications and statements from expert recommendations or professional associations were included. Current expert guidance relies mainly on scarce, anecdotal evidence, and two cadaveric studies, which have demonstrated potential aerosolization during transnasal surgery. General consensus exists for delaying surgery when possible, ascertaining COVID-19 status preoperatively and donning of adequate personal protective equipment by all operating room staff (including at minimum an N95 mask). Cold, nonpowered surgical instruments are deemed the safest, while thermal instruments (electrocautery and laser) and high-speed drills should be minimized. Conflicting recommendations emerge for use of microdebriders. Conclusion Endoscopic sinus and skull base surgery impart a potential risk of aerosolization. Hence, surgical indications, protective measures for health care workers, and surgical instrumentation must be adapted accordingly in the COVID-19 context.

Actual problems of psychological support of healthcare workers in infectious hospitals for patients with COVID-19 in the territory of the Krasnoyarsk region

This article presents the experience of implementing psychological support measures for healthcare workers of infectious hospitals for patients with COVID-19 during a pandemic. The results of an empirical study of the prevalence, severity and specificity of the development of anxiety and depressive symptoms in healthcare workers of residents of a megalopolis (Krasnoyarsk), a closed territorial district (Zelenogorsk) and seconded to the North Yenisei district of the Krasnoyarsk Territory depending on social status and professional factors of burnout are presented. The stages of the implementation of measures of psychological support for the activities of healthcare workers are described. A comparative analysis of the involvement of employees of various infectious hospitals was carried out. Material and methods. The total sample of the study included 126 subjects (21 men and 105 women) engaged in the provision of medical care in three infectious diseases hospitals for patients with COVID-l9 in the Krasnoyarsk region. To achieve the goals and objectives of the study, the following methods were used: psychodiagnostic testing with the BDI scale, STAI test and MBI questionnaire, and statistical data processing (Spearman rank correlation coefficient, Mann-Whitney-Wilcoxon U-test). We invited 284 medical workers to participate in psychological support activities. Results and conclusions. The prevalence of subdepression among medical personnel varies from 5.5 to 30.9%, depending on the location of the infectious diseases hospital for patients with COVID-19. Severe depressive symptoms were detected in 4.46% of the total number of subjects. A low level of situational anxiety was detected in less than 30%. It has been confirmed that employees of a younger age and with less experience are more susceptible to the development of depersonalization and cognitive-affective symptoms of depression. And employees who do not have children show higher indicators of situational and personal anxiety. Moreover, despite the prevalence of alarming and depressive symptoms, there is a low involvement and unwillingness of healthcare workers to participate in psychological support activities.

COVID-19: Current Knowledge and Best Practices for Orthopaedic Surgeons.

BackgroundA mysterious cluster outbreak of pneumonia in Wuhan, China in December 2019 was traced to Severe Acute Respiratory Syndrome Coronavirus 2 and declared a Pandemic by WHO on 11th March 2020. The pandemic has spread rapidly causing widespread devastation globally.PurposeThis review provides a brief understanding of pathophysiology, clinical features, diagnosis and management of COVID-19 and highlights the current knowledge as well as best practices for orthopaedic surgeons. These are likely to change as knowledge and evidence is gained.ResultsOrthopaedic surgeons, like other front-line workers, carry the risk of getting infected during their practice, which as such is already substantially affected. Implementation of infection prevention and control as well as other safety measures for health care workers assumes great importance. All patients/visitors and staff visiting the hospital should be screened. Conservative treatment should be the first line of treatment except for those requiring urgent/emergent care. During lockdown all elective surgeries are to be withheld. All attempts should be made to reduce hospital visits and telemedicine is to be encouraged. Inpatient management of COVID-19 patients requires approval from concerned authorities. All patients being admitted to the hospital in and around containment zones should be tested for COVID-19. There are special considerations for anaesthesia with preference for regional anaesthesia. A separate Operation room with specific workflow should be dedicated for COVID-19 positive cases.ConclusionsDespite the magnitude of challenge, the pandemic offers significant lessons for the orthopaedic surgeon who should seek the opportunity within the adversity and use this time wisely to achieve his/her Ikigai.Electronic supplementary materialThe online version of this article (10.1007/s43465-020-00135-1) contains supplementary material, which is available to authorized users.

Wearing the N95 mask with a plastic handle reduces pressure injury

An outbreak of the 2019 novel coronavirus diseases (COVID-19) in Wuhan, China, has spread quickly worldwide and was recently declared a pandemic by the World Health Organization. Among the infection prevention measures for health care workers, wearing a medical N95 face mask properly is important. However, using an ear loop-style N95 face mask for a long time can cause pressure injury on the skin of the ear (Fig 1, A) that may cause people to adjust the mask constantly, putting them at higher risk of infection.

The impact of national-level interventions to improve hygiene on the incidence of irritant contact dermatitis in healthcare workers: changes in incidence from 1996 to 2012 and interrupted times series analysis.

Reducing healthcare-associated infections (HCAI) has been a priority in the U.K. over recent decades and this has been reflected in interventions focusing on improving hygiene procedures. To evaluate whether these interventions coincided with an increased incidence of work-related irritant contact dermatitis (ICD) attributed to hand hygiene or/and other hygiene measures in healthcare workers (HCWs). A quasi-experimental (interrupted time series) design was used to compare trends in incidence of ICD in HCWs attributed to hygiene before and after interventions to reduce HCAI with trends in the same periods in control groups (ICD in other workers). Cases of ICD reported to a U.K. surveillance scheme from 1996 to 2012 were analysed. The time periods compared were defined objectively based on the dates of the publication of national evidence-based guidelines, the U.K. Health Act 2006 and the Cleanyourhands campaign. The reported incidence of ICD in HCWs attributed to hygiene has increased steadily from 1996 to 2012 [annual incidence rate ratio (95% confidence interval): hand hygiene only 1.10 (1.07-1.12); all hygiene 1.05 (1.03-1.07)], whereas the incidence in other workers is declining. An increase in incidence of ICD in HCWs attributed to hand hygiene was observed at the beginning of the Cleanyourhands campaign. The increasing incidence of ICD in HCWs combined with the popularity of interventions to reduce HCAI warrants increased efforts towards identifying products and implementing practices posing the least risk of ICD.

KRZTUSIEC JAKO CHOROBA ZAKAŹNA PRACOWNIKÓW OCHRONY ZDROWIA - PRZYPADEK KLINICZNY Z KOMENTARZEM

We discuss the changing epidemiological situation of pertussis observed in recent years, with a focus on the shift of cases from young children to older age groups, teenagers and adults. Whooping cough may affect healthcare workers who belong to a high-risk group and cause hospital infections. We present a case report of pertussis in a nurse and the recommended prophylactic measures in healthcare workers. The current definition and diagnosis of pertussis is also discussed. The clinical course of pertussis can be significantly alleviated and highly non-specific, with no typical coughing and vomiting in people vaccinated against whooping cough a few years earlier. Pertussis should be considered in the differential diagnosis of cough lasting more than fourteen days. Improvement of the epidemiological situation requires, besides immunization of infants, regular and universal booster immunization for adolescents and adults. Vaccinations for health care workers of neonatal and pediatric wards are recommended in the National Program of Immunization for 2013. It seems that booster vaccination of health care workers with a triple vaccine against diphtheria, tetanus and acellular pertussis (dTpa) of the reduced quantity of antigens, particularly of health workers caring for infants, children and the elderly, may be the most effective way to reduce the risk of pertussis transmission in the health care environment.

Organizations Issue New C. diff. Guideline

Organizations Issue New C. diff. Guideline

Practical and affordable preventive measures for health care workers against nosocomial transmission of tuberculosis in resource limited settings

This review considers the occupational hazard to health care workers posed by the global increase in tuberculosis (TB), especially in multidrug-resistant tuberculosis. With the global upsurge in tuberculosis, fueled by the Human Immunodeficiency Virus infection pandemic, and the increase in multidrug-resistant tuberculosis, the condition has become a serious occupational hazard for health care workers worldwide. To document practically affordable preventive and protective measures for health care workers against nosocomial transmission of tuberculosis. The study involved library and internet search of literatures. Professional experience and personal discussion with colleagues and occupational health experts were also incorporated. This study focuses on health care workers because the nature of their work has probably the highest risk of contacting tuberculosis. The resource limited setting especially sub-Saharan Africa was targeted, because of its highest incidence of TB and HIV, its worst epidemic of HIV-related TB, and where the risk to health care workers is probably greatest. Protecting health care workers in resource limited settings involves administrative measures such as having appropriate policies and procedures in place to facilitate early diagnosis and treatment; appropriate environmental control, relevant personal protection and surveillance of health care workers. Political support and commitment should be given to research to examine the feasibility and cost-effectiveness of measures such as voluntary TB and HIV-testing of health care workers and isoniazid preventive therapy for workers in high-risk settings. All health facilities should have appropriate resources to operate control measures for nosocomial TB. Nigerian Medical Practitioner Vol. 50(1) 2006: 9-11