Protection Of Staff Research Articles

Infection Control Improvement of a Negative-Pressurized Pediatric Intensive Care Unit.

The COVID-19 pandemic caused by the novel SARS-CoV-2 virus raises alarming concern around the healthcare facilities due to the significant increase in patient inflow. Negative-pressurized isolation rooms have been utilized in various health care facilities to isolate the patients from active community contact. Several studies have highlighted isolation rooms improvement. However, limited knowledge is available regarding the isolation room facilities for pediatric intensive care units (PICU) to accommodate more than one pediatric patient. In this aspect, this study investigates a negative-pressurized isolation facility in PICU with minimal design modifications with the possibility that it can accommodate more than one pediatric patient. The field measurement tests were conducted to ensure the design compliance of Taiwan CDC. Then, computational fluid dynamics (CFD) was further utilized to numerically evaluate the HVAC system role and the ventilation performance towards infection control. A protected air-jet curtain system with a new ventilation layout was proposed through this study to enhance the protection for both pediatric patients and medical staff. The concentration decay was monitored and recorded within 900 s to evaluate the performance. The concentration can be reduced to 504 ppm for case 1, 620 ppm for case 2, 501 ppm for case 3, and 486 ppm for case 4. In addition, the injected bioaerosol particles could be well diluted dealing with two patients presents a good performance. The results revealed that this proposed configuration could feasibly accommodate two patients with a significant contamination control to protect the medical staff and patients.

A simple and cheap aerosol penetrometer for filter testing using an electronic cigarette.

Background: During the coronavirus disease 2019 (COVID-19) pandemic face masks grew in importance as their use by the general population was recommended by health officials in order to minimize the risk of infection and prevent further spread of the virus. To ensure health protection of medical personnel and other system relevant staff, it is of considerable interest to quickly test if a certain lot of filtering facepiece masks meets the requirements or if the penetration changes under different conditions. As certified penetrometers are rather expensive and were difficult to obtain during the COVID-19 pandemic, we describe two quite simple and cheap methods to quickly test the filter penetration based on an electronic cigarette. Methods: The first method uses a precision scale, the second method uses a light scattering detector to measure the filter penetration. To make sure these two methods yield reliable results, both were tested with freshly cut filter samples covering the range of approx. 2 % to 60 % filter penetration and compared to the results of a certified penetrometer. Results: The comparison of the two methods with the certified penetrometer showed a good correlation and therefore allow a quick and rather reliable estimation of the penetration. Conclusions: Several examples about the use of faulty masks and the resulting health risks show that simple, fast, cheap and broadly available methods for filter characterization might be useful in these days.

CRIMINAL PROCEDURE PROTECTION OF MEMBERS OF THE MEDICAL STAFF OR PERSONS CHOSEN TO HELP THEM (ARTICLE 276A K.P.K.)

The subject of the article is a new preventive measure introduced last year in Article 276a of the Polish Code of Criminal Procedure for the protection of the medical staff or persons chosen to help them. Authors discuss in detail the need for such a measure, its purpose and functions, the level of protection it offers, the basic grounds for its application, the various type of injunctions associated with the preventive measure, the associated surety or financial guarantee, and the period of time for which such an injunction may remain in force as well as the authorities applying the preventive measure. Due to the scale of comments, often critical, the issue discussed in the article may turn out to be useful for both legal practitioners and theoreticians.

1574 Does Use of Intra-Operative PPE Affect Post-Operative Infection Rates in Hip Fracture Patients?

AimCOVID-19 has required significant change to theatre protocol. Regional guidelines dictate full PPE must be donned for all procedures where aerosol generating procedures (AGP) occur. Additionally, no one may enter or leave theatre whilst an operation is in progress, or until 20 minutes after an AGP. We hypothesized that adopting these protocols may lead to a reduction in post-operative infection in hip fracture patients.MethodMulticentre retrospective cohort study comparing post-operative infection and return to theatre rates (<30-days post-op) from 18/03/20 to 27/04/20 with respective period in 2019. COVID-19 was considered endemic in Northern Ireland from 18/03/20. Patients were identified from the Fracture Outcomes Research Department database and relevant inpatient episode reviewed via Electronic Care Record.Results464 patients were included– 261(2020) and 203(2019). In 2019, 4 patients (1.5%) returned to theatre within 30-days, however only one was due to wound dehiscence. In 2020, 1 patient (0.5%) returned to theatre for traumatic wound dehiscence, however they had no documented infection.ConclusionsThere was no difference in post-operative complication rate requiring return to theatre within 30 days between cohorts. Whilst PPE can be considered important for protection of patients and staff against COVID-19, it may not have significant effect on post-operative infection rates.

Staff and physician protection in neurointervention during the coronavirus disease-2019 pandemic: A summary review and recommendations.

The coronavirus disease-2019 pandemic, caused by the novel severe acute respiratory distress syndrome coronavirus 2, has to date resulted in an estimated global death toll of more than 1.5 million with more than 69 million reported cases worldwide. It has become increasingly clear that delivery of effective neurointerventional clinical care means maintaining an able and safe workforce in a rapidly changing environment. Staff and physician protection has become increasingly topical and relevant within the angiography suite both in peripheral and cardiac intervention and in neurointervention. The following review outlines the types of personal protective equipment relevant to neurointerventional care, summarises society guidelines and makes recommendations for the provision of safe care to both staff and patients.

A national survey of hospital readiness during the COVID-19 pandemic in Nigeria.

IntroductionThe COVID-19 pandemic continues to overwhelm health systems across the globe. We aimed to assess the readiness of hospitals in Nigeria to respond to the COVID-19 outbreak.MethodBetween April and October 2020, hospital representatives completed a modified World Health Organisation (WHO) COVID-19 hospital readiness checklist consisting of 13 components and 124 indicators. Readiness scores were classified as adequate (score ≥80%), moderate (score 50–79.9%) and not ready (score <50%).ResultsAmong 20 (17 tertiary and three secondary) hospitals from all six geopolitical zones of Nigeria, readiness score ranged from 28.2% to 88.7% (median 68.4%), and only three (15%) hospitals had adequate readiness. There was a median of 15 isolation beds, four ICU beds and four ventilators per hospital, but over 45% of hospitals established isolation facilities and procured ventilators after the onset of COVID-19. Of the 13 readiness components, the lowest readiness scores were reported for surge capacity (61.1%), human resources (59.1%), staff welfare (50%) and availability of critical items (47.7%).ConclusionMost hospitals in Nigeria were not adequately prepared to respond to the COVID-19 outbreak. Current efforts to strengthen hospital preparedness should prioritize challenges related to surge capacity, critical care for COVID-19 patients, and staff welfare and protection.

Non-Lead Protective Aprons for the Protection of Interventional Radiology Physicians from Radiation Exposure in Clinical Settings: An Initial Study.

Radiation protection/evaluation during interventional radiology (IVR) poses a very important problem. Although IVR physicians should wear protective aprons, the IVR physician may not tolerate wearing one for long procedures because protective aprons are generally heavy. In fact, orthopedic problems are increasingly reported in IVR physicians due to the strain of wearing heavy protective aprons during IVR. In recent years, non-Pb protective aprons (lighter weight, composite materials) have been developed. Although non-Pb protective aprons are more expensive than Pb protective aprons, the former aprons weigh less. However, whether the protective performance of non-Pb aprons is sufficient in the IVR clinical setting is unclear. This study compared the ability of non-Pb and Pb protective aprons (0.25- and 0.35-mm Pb-equivalents) to protect physicians from scatter radiation in a clinical setting (IVR, cardiac catheterizations, including percutaneous coronary intervention) using an electric personal dosimeter (EPD). For radiation measurements, physicians wore EPDs: One inside a personal protective apron at the chest, and one outside a personal protective apron at the chest. Physician comfort levels in each apron during procedures were also evaluated. As a result, performance (both the shielding effect (98.5%) and comfort (good)) of the non-Pb 0.35-mm-Pb-equivalent protective apron was good in the clinical setting. The radiation-shielding effects of the non-Pb 0.35-mm and Pb 0.35-mm-Pb-equivalent protective aprons were very similar. Therefore, non-Pb 0.35-mm Pb-equivalent protective aprons may be more suitable for providing radiation protection for IVR physicians because the shielding effect and comfort are both good in the clinical IVR setting. As non-Pb protective aprons are nontoxic and weigh less than Pb protective aprons, non-Pb protective aprons will be the preferred type for radiation protection of IVR staff, especially physicians.

A Case Series: Describing the Coronavirus Pandemic Response in Small Naval OCONUS Military Treatment Facilities.

ABSTRACTIntroductionThe European SARS-CoV-2 (COVID-19) outbreak threatened military beneficiaries receiving care outside of the United States. Military treatment facilities located outside the United States were the first to respond to the pandemic, requiring immediate action to establish novel protocols. The purpose of this case series is to describe challenges, solutions, and future recommendations during a pandemic response at three small naval military treatment facilities located outside the continental United States (OCONUS).ResultsThe analysis and discussion reviews challenges in information processing, communication methods and patterns, process changes, actions for staff protection, and change fatigue experienced during this time.ConclusionsRecommendations for future work include filling the gaps in the evidence for a prolonged pandemic response and crisis management, such as the current SARS-CoV-2 pandemic, including best practices to communicate, maintain staff resilience, and manage or mitigate associated prolonged stress and uncertainty.

Performance Improvement of a Negative-Pressurized Isolation Room for Infection Control.

Negative-pressurized isolation rooms have been approved effectively and applied widely for infectious patients. However, the outbreak of COVID-19 has led to a huge demand for negative-pressurized isolation rooms. It is critical and essential to ensure infection control performance through best practice of ventilation systems and optimum airflow distribution within isolation rooms. This study investigates a retrofitting project of an isolation room to accommodate COVID-19 patients. The field measurement has been conducted to ensure the compliance with the design specification from the CDC of Taiwan. The pressure differentials between negative-pressurized isolation rooms and corridor areas should be at least 8 Pa, while the air change rate per hour (ACH) should be 8–12 times. Computational fluid dynamics (CFD) is applied to evaluate the ventilation performance and contamination control. Different layout arrangements of exhaust air have been proposed to enhance the ventilation performance for infection control. A simple projected air-jet curtain has been proposed in the simulation model to enhance extra protection of medical staff. The resulting ventilation control revealed that the contamination control can be improved through the minor adjustment of exhaust air arrangement and the application of an air-jet curtain.

Radiation Reduction and Protection for Radiosensitive Organs (Lens, Thyroid, and Genital Organs) of Patients Receiving Percutaneous Coronary Intervention-Real-World Measurement of Radiation Dose in a Single Center.

Backgrounds: Reducing radiation exposure is the basic principle for performing percutaneous coronary intervention (PCI). Many studies have confirmed the effect of radiation protection for medical staff, but studies about the effectiveness of protection for patients and real measurement of radiation dose in patients’ specific organs are lacking. Aim: To measure the radiation doses absorbed by patients’ radiosensitive organs during PCI and the effectiveness of radiation protection. Methods: A total of 120 patients were included and allocated into three groups as the ratio of 1:1:2. A total of 30 patients received PCI at 15 frames rate per second (fps), 30 patients at 7.5 fps, and 60 patients wore radiation protective hat and glasses during PCI at 7.5 fps. The radiation doses were measured at right eyebrow (lens), neck (thyroid), back (skin), and inguinal area (genital organs) by using thermoluminescent dosimeters (TLDs). Results: Dose-area product (DAP) reduced by 58.8% (from 534,454 ± 344,660 to 220,352 ± 164,101 mGy·cm2, p < 0.001) after reducing the frame rate, without affecting successful rate of PCI. Radiation doses measured on skin, lens, genital organs, and thyroid decreased by 73.3%, 40.0%, 40.0%, and 35.3%, respectively (from 192.58 ± 349.45 to 51.10 ± 59.21; 5.29 ± 4.27 to 3.16 ± 2.73; 0.25 ± 0.15 to 0.15 ± 0.15; and 17.42 ± 12.11 to 11.27 ± 8.52 μSv, p < 0.05). By providing radiation protective equipment, radiation doses at lens and thyroid decreased further by 71.8% and 65.9% (from 3.16 ± 2.73 to 0.89 ± 0.79; 11.27 ± 8.52 to 3.84 ± 3.49 μSv, p < 0.05). Conclusions: By lowering the frame rate and providing protective equipment, radiation exposure in radiosensitive organs can be effectively reduced in patients.

A Nonhybrid Model of Transitioning Pediatric to Adult Critical Care during the Coronavirus Disease 2019 Surge: A Single Unit Experience.

To accommodate the unprecedented demand for critical care beds during the first surge of the coronavirus disease 2019 (COVID-19) pandemic in the United Kingdom, hospitals had to adapt, restructure, and collaborate to provide the best possible care for the pediatric and adult populations. This single-center experience outlines the considerations our hospital took into account when planning for this restructure and the steps taken to ensure a successful execution of the task. Cross-specialty collaboration between the pediatric and adult critical care teams adopted a unique approach to care for only critically ill COVID-19 positive adult patients in the pediatric intensive care unit (PICU), transferring out critically unwell children at an early stage before the adult intensive care unit (AICU) became overwhelmed (nonhybrid model). This was designed to be in a staggered fashion, before allowing the AICU to overflow. This approach enabled the adult critical care team to support pediatric colleagues in learning the nuances of looking after critically ill adults prior to the service being saturated by the predicted supersurge. The success of the operation hinged on two things. First, PICU staff continuing to work in a familiar environment with their usual clinical team and second, the gradual and controlled admission of adult patients into PICU before the peak in demand for critical care beds. This design helped protect staff morale and build confidence in their new clinical role. The overall case fatality of invasively ventilated patients with COVID-19 in our hospital during the first surge was 32%, which is lower than the global average of 45%. This serves as evidence that this nonhybrid model is safe and sustainable.

COVID-19 Incidence and Mortality Among Long-Term Care Facility Residents and Staff in South Carolina

ObjectivesThis study explored differences in COVID-19 incidence, mortality, and timing among long-term care facility (LTCF) residents and staff with those living in the community in South Carolina (SC). DesignLongitudinal secondary data analysis. Setting and ParticipantsAdults age ≥18 in SC with confirmed COVID-19 diagnosis from 3/15/2020 and 1/2/2021 (n = 307,891). MethodsCOVID-19 data came from the SC Department of Health and Environmental Control (SCDHEC). We included all COVID-19 cases, hospitalizations, and deaths among adult residents. Residence and employment in LTCF were confirmed by SCDHEC. Descriptive statistics and trends for cases, hospitalizations, and deaths were calculated. We used Cox proportional hazards to compare COVID-19 mortality in LTCF residents and staff to community dwelling older adults and adults not employed in LTCF, respectively, controlling for age, gender, race, and pre-existing chronic health conditions. ResultsLTC residents experienced greater incidence of cases throughout the study period until the week ending on 1/2/21. LTCF residents with COVID-19 were more likely to be hospitalized compared to older adults in the community and 74% more likely to die (HR: 1.74, 95% CI: 1.59-1.90), after adjusting. LTC staff experienced greater incidence of cases compared to adults not employed in LTCF until the week ending on 12/26/2020, while experiencing similar incidence of death compared to the similar community members. After adjusting, LTC staff had 0.58 (HR = 0.58; CI: 0.39-0.88) times lower hazard of death compared to community members that did not work in a LTCF. Conclusions and ImplicationsNarrowing of the gap between LTCF and community-wide infection and mortality rates over the study period suggests that early detection of COVID-19 in LTCFs could serve as a first indicator of disease spread in the greater community. Results also indicate that policies and regulations addressing staff testing and protection may help to slow or prevent spread within facilities.

Quantitative microbial risk assessment of human norovirus infection in environmental service workers due to healthcare-associated fomites

Healthcare-associated norovirus outbreaks place a large burden on healthcare staff. Environmental service workers (ESWs), however, remain understudied despite high contact with potentially contaminated surfaces. Understanding the magnitude of the risk of norovirus infection in healthcare ESWs can protect workers and improve infection control. This study simulated the risk of norovirus infection for unprotected ESWs after a single fomite contact, assuming no disinfection or protective equipment, in norovirus-positive patient rooms. In addition, the risk of secondary surface transmission from norovirus-exposed ESWs was simulated. A quantitative microbial risk assessment employing two-dimensional Monte Carlo simulation with parameters extracted from the literature was used to estimate norovirus infection from multiple fomite contact scenarios defined by: norovirus source (patient vomit/diarrhoea), location (bathroom/patient room) and target outcome (ESW/secondary illness). Unprotected ESWs have a maximum estimated risk of norovirus infection of 33% (1:3) for a single fomite contact in a room where a norovirus-positive patient had a diarrhoeal event. Patient vomit events lead to fomite contact risk estimates that are four orders of magnitude lower than those for diarrhoeal events. The estimated risk of secondary illness from touching a common surface is as high as 25% (1:4) after single fomite exposure following a diarrhoeal event. A single fomite contact may lead to sizable risk of norovirus infection in ESWs if personal protective equipment and disinfection are not used appropriately. ESWs can also transfer virus to secondary surfaces, initiating further infections. Interventions are needed to reduce fomite transfer of norovirus, and protect patients and staff from nosocomial infections.

Current best practice recommendations for safe dental Practice in the COVID-19 era

Methods: The researchers conducted a thorough review of the American Dental associations (ADA), Advisory Taskforce on Dental Practice Recovery, CDC (Centers for disease controls &amp; Prevention, USA) guidelines for providing dental care during Covid-19 pandemic to protect the dental personal, OSHA’s (Occupational safety and health administration, US Government agency) supplemental interim guidelines for dental workers and employers related to control and prevention of Covid-19 &amp; the UK’s National Health Services (NHS) proposed guidelines for standard operating procedures for urgent dental care during covid-19 pandemic. Results: Systematically laid down and concisely presented infection control, administrative and engineering control guidelines from top international organizations. Step by step guidelines beginning from pre-appointment screening, in office registration process, chairside protocols to staff protection protocols are presented. Special focus on aerosol/droplet/fomite generating procedures and prevention of infection through judicious use of PPE’s and other novel disinfection techniques including administrative and engineering controls. Conclusion: Covid-19 pandemic is a unique and once in a generation crisis for the practice of dentistry globally. Most dental professionals are limiting themselves to emergency treatments as per local guidelines. There is an urgent need to ensure state of the art and scientifically authentic guidelines are presented to the dental community to alleviate their anxiety so that they can begin to practice dentistry without the uncertainty and fear that Covid-19 has brought upon the dental fraternity. Keywords: COVID-19; dental practice; CDC guidelines; viruses.

A novel use for routine CBCT imaging during radiotherapy to detect COVID-19

IntroductionThoracic CT is a useful tool in the early diagnosis of patients with COVID-19. Typical appearances include patchy ground glass shadowing. Thoracic radiotherapy uses daily cone beam CT imaging (CBCT) to check for changes in patient positioning and anatomy prior to treatment through a qualitative assessment of lung appearance by radiographers. Observation of changes related to COVID-19 infection during this process may facilitate earlier testing improving patient management and staff protection. MethodsA tool was developed to create overview reports for all CBCTs for each patient throughout their treatment. Reports contain coronal maximum intensity projection (MIP's) of all CBCTs and plots of lung density over time. A single therapeutic radiographer undertook a blinded off-line audit that reviewed 150 patient datasets for tool optimisation in which medical notes were compared to image findings. This cohort included 75 patients treated during the pandemic and 75 patients treated between 2014 and 2017. The process was repeated retrospectively on a subset of the 285 thoracic radiotherapy patients treated between January–June 2020 to assess the efficiency of the tool and process. ResultsThree patients in the n = 150 optimisation cohort had confirmed COVID-19 infections during their radiotherapy. Two of these were detected by the reported image assessment process. The third case was not detected on CBCT due to minimal density changes in the visible part of the lungs.Within the retrospective cohort four patients had confirmed COVID-19 based on RT-PCR tests, three of which were retrospectively detected by the reported process. ConclusionThe preliminary results indicate that the presence of COVID-19 can be detected on CBCT by therapeutic radiographers. Implications for practiceThis process has now been extended to clinical service with daily assessments of all thoracic CBCTs. Changes noted are referred for oncologist review.

OCCUPATIONAL HEALTH AND SAFETY OF HEALTH CARE WORKERS IN COVID 19: A RISING CONCERN IN INDIA

The COVID-19 pandemic has put a strain on healthcare services all over the world. With the rising range of healthcare providers diagnosed with COVID globally and with the second wave in India, the crisis has gained global attention and assistance. The healthcare system in India is under strain, putting frontline healthcare staff on edge. Long and exhausting work hours, quickly depleting supplies of personal protective equipment, day-to-night news reports of COVID-19 statistics, inadequate availability of particular drugs, and insufficient societal assistance may all lead to the additional emotional strain of these HCWs. Depression, anxiety, insomnia, and stress are very prevalent among HCWs. Employed in the high-risk division like infectious disorder and pulmonology, and to see a family member that has been diagnosed, deficient or inadequate hand hygiene before and after interaction with patients, insufficient PPE, direct patient interaction (12 times a day), long daily contact hours (15 hrs), and uncontrolled exposure were all linked to COVID-19 risk among Health Care Workers. Working with COVID-19 has demonstrated the interdependence of various components of the work system, such as personal protective equipment (PPE), ventilators, monitoring equipment, staffing, work setting, and so on. Healthcare workers should also implement a detailed ‘infectious disease preparedness and recovery strategy' to train and protect staff before and after a pandemic. Workers must be closely watched, supported, and, when possible, supplied with evidence-based practice after the crisis has passed.

Knowledge, attitude, and behavior of Turkish dentists about radiation protection and radiation safety.

Dentists use dental imaging methods frequently in the diagnosis and treatment of dental diseases. This study aimed to determine dentists' knowledge, attitudes, and behaviors about radiation protection during dental imaging procedures. Dentists from two major dental health centres in İzmir province were asked to participate in this study. The participants replied to a questionnaire that consisted of questions on the use of radiographic devices, knowledge on the radiation protection of patients and staff, and attitudes and behaviors regarding radiation protection. The questionnaire also included questions about the socio-demographic characteristics of the participants. Descriptive statistics of data were performed using the SPSS software program. Sixty-six dentists participated in the survey. The mean knowledge score of dentists on dental imaging, radiation, and radiation protection was 8.3 ± 2.6 out of 17, while the mean attitude and behavior score was 8.3 ± 2.1 out of 27.97% of the participants stated that medical imaging technicians should carry out imaging procedures. The use of rectangular collimators was 9.1%, and using E/F film was 56.3% among dentists. 23.3% of participants stated that they applied the bisecting angle technique during dental imaging, 23.8% stated that they wear a lead apron during imaging, and 37.8% stated that they always used thyroid shields on the patients. In addition, 37.2% of the dentists stated that the patient holds the film during preapical radiography, and 81.5% used the same imaging parameters for adult and pediatric patients. 62% of dentists stated that they question the pregnancy of female patients before imaging. Findings of the study suggest that the knowledge of dentists about dental imaging procedures and radiation protection needs to be improved. The implementation and the follow-up of quality training programs in accordance with the standards set by the national authority will be of great importance.

A simple and cheap aerosol penetrometer for filter testing using an electronic cigarette.

Background: During the coronavirus disease 2019 (COVID-19) pandemic face masks grew in importance as their use by the general population was recommended by health officials in order to minimize the risk of infection and prevent further spread of the virus. To ensure health protection of medical personal and other system relevant staff, it is of considerable interest to quickly test if a certain lot of filtering facepiece masks meets the requirements or if the penetration changes under different conditions. As certified penetrometers are rather expensive and were difficult to obtain during the COVID-19 pandemic, we describe two quite simple and cheap methods to quickly test the filter penetration based on an electronic cigarette. Methods: The first method uses a precision scale, the second method uses a light scattering detector to measure the filter penetration. To make sure these two methods yield reliable results, both were tested with freshly cut filter samples covering the range of approx. 2 % to 60 % filter penetration and compared to the results of a certified penetrometer. Results: The comparison of the two methods with the certified penetrometer showed a good correlation and therefore allow a quick and rather reliable estimation of the penetration. Conclusions: Several examples about the use of faulty masks and the resulting health risks show that simple, fast, cheap and broadly available methods for filter characterization might be useful in these days.

Are preventive measures adequate? An evaluation of the implementation of COVID-19 prevention and control measures in nursing homes in China

BackgroundThe novel coronavirus disease 2019 (COVID-19) pandemic has become a challenge for nursing homes in China. Nursing homes are particularly dangerous places in terms of the spread of COVID-19 given that they house vulnerable, high-risk populations. As such, several useful guidelines for coping with COVID-19 in nursing homes have been provided. However, the actual implementation rates of such guidelines are unknown. This study aims to document the adherence of nursing homes to the Ministry of Civil Affairs guidelines for COVID-19 prevention and control in nursing homes.MethodsA cross-sectional study was conducted among 484 nursing homes in 136 cities of 28 provinces in China. A self-report questionnaire was created based on the Ministry of Civil Affairs guidelines for COVID-19 prevention and control in nursing homes (first edition). The questionnaire and the Transformational Leadership in the Public Sector Scale were sent to nursing home managers via the Wenjuanxing app online from February 7 to 29, 2020. Ultimately, 461 of 960 nursing homes participated, for a response rate of 48.0%.ResultsThe average overall implementation rate of COVID-19 prevention and control measures was 80.0% (143.97/180). The average implementation rates for hygienic behaviour management and access management were lower, at 75.3 and 78.7%, respectively. Number of medical staff and transformational leadership score of nursing home’s manager were associated with total implementation score (p < 0.05). A total of 69.8% (322/461) of the nursing home managers had serious resource problems, and inadequate protective supplies (72.0%) and staff shortages (47.7%) were the two primary problems. The nursing homes that located in urban, with large nursing home size, had hospital-nursing home cooperation and the transformational leadership score of manager> 60, had a lower risk of having serious resource problems.ConclusionsOverall, the implementation of prevention and control measures by nursing homes are insufficient during the epidemic in China. More medical staff, adequate resource, cooperation with hospitals, and higher transformational leadership of manager are required to improve the implementation rate. It is urgent for nursing homes to maintain the safety of residents and staff.

Investigation on Occupational Protection and Exposure of Medical Staff in the Diagnosis and Treatment of COVID-19 in Sichuan

Background: We investigated the contact status of medical staff with confirmed or suspected patients with COVID-19 in Sichuan Province, China, as well as the use of personal protective equipment at the time of contact, and we explored the factors affecting the effective use of personal protective equipment. Methods: We performed a cross-sectional study by distributing a questionnaire on occupational protection and exposure of medical staff in the diagnosis and treatment of COVID-19 using a convenience sampling method for online surveys from February 23 to February 29, 2020. Results: In total, 13,829 valid questionnaires from 644 hospitals in Sichuan Province were retrieved, and 802 people were exposed to confirmed or suspected patients with COVID-19, accounting for 5.80%. 688 (85.79%) of 802 people who reported that they had taken effective personal protection measures for each exposure. Sex, work department, and length of service were the independent factors influencing the effective use of personal protective equipment in multivariate analysis (P &lt; .05). Conclusions: Medical institutions need to continue to strengthen the training regarding standard precautions and personal protection, especially for general departments other than fever clinics and isolation wards, as well as medical staff with few working years, to ensure the occupational safety of medical staff.Funding: NoDisclosures: None