Infection Control Training Research Articles

Advancing Staff Safety: Assessment of Quality Improvement Interventions in Reducing Needlestick Injuries Among Staff at Nyaho Medical Centre.

Needlestick injury, which occurs when the skin is accidentally punctured, is linked to infection transmission of HIV, hepatitis B, and hepatitis C. Because of the associated risks, hospitals are keen to do everything necessary to prevent needlestick injuries to their staff. This is a quality improvement project aimed at reducing needlestick injuries among staff at Nyaho Medical Centre (NMC). A facility-based assessment of the incidence of needlestick injury recorded and quality intervention employed was conducted between 2018 and 2021. Quality improvement tools such as the fishbone (cause and effect analysis) and the run chart were used to analyze and evaluate improvements made over time. NMC staff have greatly reduced the incidence of needlestick injuries from 2018 to 2021 (from 11 needlestick injuries in 2018 to 3 recorded needlestick injuries in 2021). Using root cause analysis to investigate the possible cause of needlestick injury and use of the run chart to monitor the implemented improvement strategies (interventions) helped reduce the incidence of needlestick injuries among staff and thereby improved staff safety. The introduction of the incident reporting management systems saw an increase in the culture of incident reporting in general. Other incidents, such as medical errors and patient falls, were being reported using the incident reporting system. The inclusion of infection prevention and control training as part of NMC's onboarding for new employees helped in the knowledge and awareness creation of needlestick injuries and safety measures to prevent injury from needles and sharps. Policy changes and audit with feedback sharing key performance indicators with frontline team members were identified to have had the most effect.

Patient Safety: A Systematic Review of the Literature with Evidence based Measures to Improve Patient Safety in Healthcare Settings

Patient safety is a crucial component of healthcare delivery aimed at minimizing and preventing medical errors that can cause harm or injury to patients. This systematic review identified 50 studies that evaluated interventions aimed at improving patient safety in healthcare settings, including medication reconciliation, surgical safety checklists, hand hygiene programs, and electronic health record systems. The findings suggest that most interventions led to significant improvements in patient safety outcomes, including a reduction in adverse events and preventable harm. Evidence-based measures to improve patient safety include effective communication, hand hygiene, medication safety, patient identification, fall prevention, surgical safety, infection control, and staff training. The implementation of these measures can help improve patient safety and reduce the risk of harm to patients in healthcare settings. Further research is needed to identify the most effective interventions and to evaluate the long-term impact of these interventions on patient outcomes. Keywords: Adverse events, Interventions, Medical errors, Patient safety, Preventable harm.

FIRST REPORT ON GASTROINTESTINAL PARASITE (GIP) INFECTION AMONG GERIATRIC COMMUNITY WITH COGNITIVE IMPAIRMENT IN SELANGOR, MALAYSIA


 
 
 Immunosenescence often changes intestinal flora and increases gastrointestinal parasite (GIP) infection susceptibility. This is potentially exacerbated by cognitive and functional decline. This study, therefore, aimed to determine the burden of GIP among older adults in institutional care. This cross-sectional study involved coprological screening and a quantitative survey among thirty-seven (n=37) residents from two nursing homes in Kajang, Selangor. Demographic data and information on the subject were collected through face-to-face interviews with caregivers and participating residents regarding their daily hygiene practice before stool sample collection. Gastrointestinal parasite (GIP) was identified by formalin-ethyl sedimentation technique and stained using Trichrome and Acid-fast. GIP was present among 34 (91.9%) of residents, 32.4% monoparasitism, 52.9% biparasitism and 14.7% polyparasitism. Up to five species were recovered, including Blastocystis spp (51.6%) and Cryptosporidium spp. (38.7%). Those of older age have increased GIP prevalence. The health impact of GIP presence in nursing homes should be a topic of future research, as well as the potential effect of infection control training among nursing home workers on GIP load in residents.
 
 

Evaluation of the Effectiveness and Perceived Benefits of Interventional Structured Infection Prevention and Control Training Module Introduced in the Undergraduate Medical Curricula.

Assessing and improving infection prevention and control (IPC) knowledge and practicing skills among medical students who are the future medical practitioners is crucial for reducing the burden of healthcare-associated infections (HAIs). In this study, we assessed the IPC knowledge of undergraduate clinical-year medical students before and after interventional IPC modular training and evaluated the effectiveness and students' perception on structured modular IPC training presented to them. This cross-sectional interventional study was conducted on single medical cohort comprising of 145 final-year undergraduate medical students of the academic year 2022-23 at COMHS. Pre-test, post-test, and feedback questionnaire were used as the assessing tools. The data were collected, entered into Excel sheet, and analyzed using SPSS software version 22. McNemar and Paired-T tests were carried out, and a p value<0.05 was considered significant. Feedback of the questionnaire was analyzed using 3 Point Likert Scale as agree, neutral, and disagree. Overall, mean IPC knowledge scores after training (37.65±1.37) was significantly higher as compared to before training (25.13±4.51). Prior knowledge scores on certain aspects of IPC such as duration of hand washing, steps of hand washing, sequence of donning and doffing of PPE, use of N95 mask, and appropriate sharp and needle precautions, and biomedical waste management were varied from 13.6% to 65.6%. However, overall participants' knowledge (p value <0.001) on these aspects increased significantly after the training. The majority of the participants (>90%) perceived IPC training as an excellent tool to improve IPC knowledge and practicing skills. IPC training had a significant impact in gaining adequate IPC knowledge and practicing skills among our participants. Therefore, it is recommended that IPC training should be implemented in the undergraduate medical curriculum with greater emphasis on practicing skills.

COVID-19 pandemic in long-term care: An international perspective for policy considerations

This paper identifies key factors rooted in the systemic failings of the long-term care sector amongst four high income countries during the COVID-19 pandemic. The goal is to offer practice and policy solutions to prevent future tragedies. Based on data from Australia, Canada, Spain and the United States, the findings support evidence-based recommendations at macro, meso and micro levels of practice and policy intervention. Key macro recommendations include improving funding, transparency, accountability and health system integration; and promoting not-for-profit and government-run long-term care facilities. The meso recommendation involves moving from warehouses to “green houses.” The micro recommendations emphasize mandating recommended staffing levels and skill mix; providing infection prevention and control training; establishing well-being and mental health supports for residents and staff; building evidence-based practice cultures; ensuring ongoing education for staff and nursing students; and fully integrating care partners, such as families or friends, into the healthcare team. Enacting these recommendations will improve residents’ safety and quality of life, families’ peace of mind, and staff retention and work satisfaction.

In-Flight Infection Prevention and Control Training for Cabin Crew in China: A Qualitative Study

Specific in-flight infection prevention and control (IPC) training was deemed an essential strategy for ensuring the implementation of appropriate measures to protect the health of passengers and crew sustainably during COVID-19 and the post-pandemic period. This study aims to identify cabin crew’s IPC duties and investigate the current status of the in-flight IPC training for cabin crew in China. The snowballing technique was employed with purposeful sampling. A total of 15 participants, including cabin crew of various positions, inspectors, and trainers from eight airlines in China were invited to attend the in-depth semi-structured interview between September and November of 2022. Cabin crew IPC duties can be classified into four phases based on a thematic analysis: before flight, passenger boarding, during flight, and after flight. The findings indicated airlines in China required their cabin crew to carry out strict IPC measures onboard throughout all stages of flight, including in-flight IPC training before flight, being aware of COVID symptoms and monitoring passengers’ conditions during boarding, the standard operating procedure (SOP) of handling suspicious carriers during flight, and so on. Meanwhile, six major themes concerning cabin crew’s in-flight IPC training were extracted: COVID-19 information, IPC Supplies and usage, IPC measures onboard, communication and explanation, information collection and report up, attitude and perceptions toward COVID-19, and IPC measures. Cabin crew were regularly trained on in-flight IPC through online learning, with face-to-face training used as reinforcement. Although training for knowledge and technical skills was deemed comprehensive, non-technical skills such as communication and explanation were viewed as a weak link. Moreover, airlines should make greater efforts to help cabin crew develop a positive attitude towards COVID-19 and overcome their internal fears. This study pointed out the shortcomings of the in-flight IPC training for cabin crew in China and can help the airlines improve the training program so that cabin crew can perform their duties correctly. Furthermore, the result can inform the development of future cabin crew training programs for the post-pandemic period.

Infection control knowledge and practices among radiographers at government hospitals in the Gaza Strip-Palestine: A cross-sectional study

IntroductionInfections acquired in hospitals are a major concern for patients, professionals and policymakers. They have an impact on the morbidity and mortality rates, length of stay, and microbial resistance. Radiology departments are at high risk for nosocomial infections, and radiographers must adhere to infection control protocols to avoid contracting illnesses and the spread of pathogens. The purpose of this study was to assess radiographers' knowledge and practise of infection control and standard precautions in the Gaza Strip-Palestine government hospitals and to identify the factors that impede radiographers' implementation of infection control. MethodsA hospital-based descriptive cross-sectional study design was applied. A self-administered questionnaire survey with 24 items was developed and distributed to examine radiographers' knowledge and practise of nosocomial infections control and standard precautions from September 2019 to February 2020. Descriptive and inferential statistics were generated using SPSS version 20. ResultsWith a response rate of 86.6%, 73 males and 37 females out of a total of 127 radiographers participated in this study. The vast majority of radiographers, 86 (78.2%), have never been trained in infection control. Total levels of knowledge and practise were 74.4% and 65.2%, respectively which corresponded to moderate levels. Age had a statistically significant impact on both knowledge and practise scores (P = 0.002 and p = 0.019, respectively). In addition, the differences between radiographers' years of work experience and their ratings on knowledge and practise were statistically significant (P = 0.001 and p = 0.011, respectively). A heavy workload, insufficient time, and a lack of training were the main barriers to implementing infection control measures in hospitals. ConclusionPalestinian radiographers reported a moderate level of knowledge and practise of infection control. The majority of radiographers have never had formal infection control training. Implications for practiceThis paper has highlighted the need for a continuing education and training programme for practising radiographers to improve their performance in infection control measures.

Practical Model of Infection Prevention and Control in Intensive Care Units for Iran

Background and Objectives: Nosocomial infections, especially in intensive care units as well as increased mortality and costs associated with them are considered as one of the major health problems in the communities so that successful control of them requires awareness on their problems in the hospitals and a precise planning. This study was conducted to "provide a model for prevention and control of nosocomial infections in intensive care units". Methods and Materials: This qualitative study was conducted through purposeful sampling strategy on 21 healthcare providers selected via purposive sampling from various medical subgroups, including: anesthesiologist, nurse manager, supervisors, faculty members, head nurses, and hospital managers. The data were collected using semi-structured interviews and conventional content analysis method was used for data analysis. In the second phase, a comparative study of the situation of our country and targeted countries was conducted and in the third phase a practical model is designed. Results: The results of qualitative content analysis using conventional approach in the field of staff's experiment regarding the model of prevention and control of nosocomial infections in intensive care units, revealed 3 main themes: "barriers (human factors, environmental factors, personal factors and complexity)", "facilitating factors (organizational, external and internal stimuli) ", and "concepts of the model (effectiveness of infection control training process in ICU, the systematic nature of the process of infection control, public hospital management, resource management and organizational leadership)". After a comparative study, the applied model of control and prevention of nosocomial infection in the ICU was designed with seven models, including standards (caring-curing and structural), monitoring and supervision, education and training, logistic resources, modern technologies, translation and knowledge transfer and evidence-based practice. Conclusion: Identifying the barriers and facilitating factors of nosocomial infection control and the use of especial measures in ICU promote the patient's safety and enhance the quality of care. Prevention of these infections requires a comprehensive and integrated controlling program. This model can be applied to resolve existing gaps and cause maximum integrity between the concepts.

The development and validation of screening tools for semi-automated surveillance of surgical site infection following various surgeries.

Surveillance of surgical site infections (SSIs) is essential for better prevention. We developed a screening method for SSIs in adults. The training dataset included data from patients who underwent orthopedic surgeries (N = 1,090), colorectal surgeries (N = 817), and abdominal hysterectomies (N = 523) during 2015-2018. The gold standard for the validation of the screening tool was the presence of SSI as determined by a trained infection control practitioner, via manual full medical record review, using the US Center for Disease Control and Prevention criteria. Using multivariable regression models, we identified the correlates of SSI. Patients who had at least one of these correlates were classified as likely to having SSI and those who did not have any of the correlates were classified as unlikely to have SSI. We calculated the sensitivity and specificity of this tool compared to the gold standard and applied the tool to a validation dataset (N = 1,310, years 2019-2020). SSI was diagnosed by an infection control specialist in 8.2, 5.2, and 31.2% of the patients in the training dataset who underwent hysterectomies, orthopedic surgeries and colorectal surgeries, respectively, vs. 6.2, 6.6, and 25.5%, respectively, in the validation dataset. The correlates of SSI after abdominal hysterectomy were prolonged hospitalization, ordering wound or blood culture, emergency room visit and reoperation; in orthopedic surgery, emergency room visit, wound culture, reoperation, and documentation of SSI, and in colorectal surgeries prolonged hospitalization, readmission, and ordering wound or blood cultures. Area under the curve was >90%. The sensitivity and specificity (95% CI) of the screening tool were 98% (88-100) and 58% (53-62), for abdominal hysterectomy, 91% (81-96) and 82% (80-84) in orthopedic surgeries and 96% (90-98) and 62% (58-66) in colorectal surgeries. The corresponding values for the validation dataset were 89% (67-97) and 75% (69-80) in abdominal hysterectomy; 85% (72-93) and 83% (80-86) in orthopedic surgeries and 98% (93-99) and 59% (53-64) in colorectal surgeries. The number of files needed to be fully reviewed declined by 61-66. The presented semi-automated simple screening tool for SSI surveillance had good sensitivity and specificity and it has great potential of reducing workload and improving SSI surveillance.

Education and training for infection prevention and control provided by long-term care homes to family caregivers: a scoping review protocol.

The objective of this review is to map the infection prevention and control education and training that long-term care homes use with families during a pandemic or infectious outbreak. During the COVID-19 pandemic, restrictions were imposed on visits to long-term care homes to decrease the risk of virus transmission. These restrictions had negative consequences for both residents and families. A scoping review of infection prevention and control education and training used with families will inform family visitation practices and policies during future infectious outbreaks. This review will examine literature describing infection prevention and control education and training provided to families in long-term care homes. Research and narrative papers, including experimental, quasi-experimental, descriptive observational quantitative and qualitative studies, reviews, text, policy, and opinion papers, will be considered for inclusion. A 3-step approach will be followed, in line with the JBI methodology for scoping reviews. Published literature will be searched for in databases including CINAHL, Embase, ERIC, MEDLINE, and AgeLine. Published and unpublished papers will be considered from 1990 to the present, in English or in French. The World Health Organization, Centers for Disease Control, and the Public Health Agency of Canada websites will be searched for unpublished and gray literature. Two authors will independently review and assess studies for inclusion and extract the data. The findings will be charted in a narrative summary and tables.

Assessing Infection Control Knowledge and Compliance of Cardiovascular Perfusionists in Theatre at a Private Hospital in Kwazulu-Natal, South Africa

Infections acquired in a hospital (HAI) often referred to as nosocomial infections are related with increasing morbidity and death among patients that are hospitalised and are predisposed to an elevated risk of infection by health workers (HCWs). The need to maintain an effective infection prevention and control program is therefore essential for quality health care. This study sought to assess the knowledge and compliance of infection control practices of Cardiovascular Perfusionists in theatre at a private healthcare facility in KwaZulu-Natal (KZN) in the city of Durban. We conducted a qualitative study based on in-depth interviews with 12 Cardiovascular Perfusionists (CP) who were purposively selected from private sector. The interviews lasted between 20 to 25 minutes and were transcribed, and then thematic analysis were applied using NVivo. The study found that there is a need for Clinical Technologist specialising in Cardiovascular Perfusion to undergo training in infection control and prevention practices at the higher education and training level. Subsequently, the study reveals that Cardiovascular Perfusionists have a good overall understanding of pathogens and the implications thereof. The study also notes that there is considerable compliance to infection control practices in theatre irrespective of the knowledge pertaining to infection control and prevention policies. We concluded that there is an overall good knowledge and understanding regarding infection control practices, although many felt that there exists an inequitable application of infection control policies due to professional biases.

Infection control and COVID-19 outbreak training at elderly care facilities.

Fatalities caused by pneumonia and underlying diseases from COVID-19 infection show the highest relative frequency among elderly people. Long-term care facilities for elderly people have continued to be the areas most vulnerable to COVID-19. We examined the effectiveness of training for infection control and COVID-19 at elderly care facilities. After sending questionnaires to all long-term elderly care facilities in Ibaraki prefecture, Japan during January 18-29, 2022, we received useful responses from 98 facilities. Using logistic regression, we regressed a dummy variable for outbreak experience to dummy variables representing routine but partial training, routine training for all staff members, long-term care facilities for elderly people, numbers of nurses, and numbers of residents. Outbreak experiences of two types were inferred, as represented by a dummy variable for a COVID-19 outbreak at the facility, and by a dummy variable for outbreak experience at the facility before COVID-19 was found. Multivariate analysis indicated routine training for all staff members as the most effective, in fact the only effective, countermeasure against COVID-19 outbreak.

Implementation Status of Airborne Infection Control Measures in Primary and Secondary Public Health Facilities, Puducherry: A Mixed-Methods Study.

Poor ventilation in healthcare settings is a concern for airborne infections, particularly in light of the potential for coronavirus disease 2019 (COVID-19) transmission. This study aimed to assess the implementation status of airborne infection control (AIC) measures in primary and secondary public healthcare facilities (HCFs) and to explore the facilitating factors and barriers in the implementation of AIC measures. A mixed-methods approach was adopted, which includes a cross-sectional descriptive study using a checklist to collect data on the implementation of AIC measures in 22 primary and two secondary public HCFs in Puducherry, South India, between October 2020 and February 2021. Further, key informant interviews (KIIs) were conducted among medical officers (MOs). The qualitative data were manually analyzed, and transcripts created from handwritten notes and audio recordings were deductively evaluated. Of the twenty-four health facilities visited, 54.2% had infection control (IC) committees. Annual IC training was held for housekeeping staff, MOs, nurses, and laboratory technicians in 23 (95.8%), 21 (87.5%), 20 (83.4%), and 14 (58.4%) facilities, respectively. Respiratory symptomatic patients were counseled on cough etiquettes in 22 (91.6%) facilities. Adequate cross-ventilation was present in outpatient departments in 16 (66.6%) institutions. N95 masks and face shields were provided in 21 (87.5%) facilities. Training through the KAYAKALP program and the presence of a separate sputum collection area were facilitators of IC, while lack of patient adherence and delays in fund release were found as barriers. Overall, the AIC measures were well-implemented, but improvements are needed in infrastructure development for patient segregation in outpatient departments and dedicated AIC training for all healthcare personnel.

The “Crisis and Concerns: A cross-sectional study on Junior Doctors during COVID-19 pandemic”.

Introduction: Doctors committed to the care of patients are trying to fulfill their duty in a difficult situation, but the consequential impacts of COVID-19 outbreak on Junior Doctors mental health are far too complex.Objective: The objective of this study was to gain insight into Junior Doctors’levels of concerns during a global pandemic of COVID-19.Methods: A quantitative cross-sectional study, utilizing a 23-item validated questionnaire was conducted on two hundred and fifty doctors of various disciplines and nationalities working on training and non-training posts.Results: The response rate was (77 %) and the levels of concern score among Junior doctors during COVID-19 pandemic in the NHS was found to be (41.35±4.9). With regard to gender differences, 32.5% of males and 27.5% females had a moderate concern score of 40 to 47. In regard to safety at work (85%) agreed that they are not safe,(100%) agreed that they are at risk to contract a COVID-19 infection at work and (100%) felt that they will transmit COVID-19 to their families but (95%) agreed that were obliged to take care of patients. In addition, (97.5%) doctors were not confident with the current infection control measures and (77.5%) felt frustrated with poor infection control training offered to them.Conclusion: Therefore, measures to strengthen personal protection and adequate support to Junior Doctors should be addressed urgently by the Healthcare system.KEYWORDS: COVID-19, Doctors, PPE, Concerns, Psychological impact.&#x0D;

1910. A Highly Effective ID Physician and Infection Preventionist-led Interactive Webinar Series for Infection Prevention and Control Training Among Frontline Healthcare Workers

Abstract Background Nebraska Infection Control Assessment and Promotion Program (ICAP) is funded by Nebraska Department of Health and Human Services through Centers for Disease Control and Prevention (CDC) grants to support Infection Prevention and Control (IPC) activities in the state. In early 2022, ICAP launched COVID-19-specific basic infection prevention and control (IPC) training to frontline healthcare providers (HCPs) through a discussion-based webinar series using curricular materials created by the CDC Project Firstline. Here, we report pre- and post-training survey responses demonstrating improvement in participants' perceived knowledge across a number of IPC domains. Methods Training was completed over a 14-week period via a weekly, interactive 30-minute webinars with a new topic covered each week. A survey was administered to participants prior to the webinar series and at the conclusion of training to assess effectiveness. The pre-survey evaluated HCP confidence in their knowledge of each of the 14 topics to be covered in the course. The post-survey evaluated both confidence and perceived value in each of the training topics. Results Prior to the training series, a mean 40.3% of participants judge themselves “very confident” in IPC topics, versus 52.7% “somewhat confident” and 7.1% “not confident” (figure 1); by the end of the training, these levels had improved to 85.4%, 14.3%, and 0.4%, respectively (figure 2). The largest gains in the category “very confident” concerned “source control” (+65%) and “COVID-19 variants” (+63%). A majority of participants perceived each topic covered in the series to be “very valuable” (figure 3); 98% of participants indicated interest in a future IPC training series and 95% indicated that they would recommend the training series to a colleague. Figure 1Results of a pre-course survey on knowledge of training topics completed by participants.Figure 2Results of a post-course survey on knowledge of training topics completed by participants.Figure 3Results of a post-course survey on value of the training course completed by participants. Conclusion This survey data suggests that a discussion-based webinar using CDC Project Firstline materials is highly effective at conveying fundamental concepts in infection control to frontline HCPs. Moreover, HCPs rated themselves as likely to return, suggesting this format is a promising modality for simple and widespread dissemination of IPC training. Disclosures M. Salman Ashraf, MBBS, Merck &amp; Co. Inc: Grant/Research Support.

Dentist’s Experiences and Perceptions One Year into the SARS-CoV-2 Pandemic

The emergence of SARS‐CoV‐2 mobilized the dental profession to make dentistry safer. Enhanced infection control protocols intended to prevent exposure to SARS-CoV-2 will likely be compromised if infection control knowledge and practice are deficient. One year into the coronavirus pandemic, the aim of this online survey among dentists in Spanish-speaking countries and Brazil, was to assess their personal experiences with COVID-19, perceptions of risk, and infection control needs. A questionnaire designed in Google Surveys was conducted in Spanish or Portuguese from April 8 to May 24, 2021. Items included were dentists’ age, sex, professional profile, and personal experience with COVID-19. Collected in a Likert-type scale, perception items covered concerns, needs, procedures, impact, and immunization. Chi2 test was applied to analyze trends in perceptions versus demographics. Responses were obtained from 712 dentists (235 men and 477 women, 23 to 75 years old). Most knew someone with COVID-19, for 61% the case was a family member. Twenty percent (n=140) had suffered COVID-19. Percentages in total agreement were: “I work with fear of COVID-19” 27%; “We need to improve infection control education” 46%; “I sterilize dental handpieces” 51%; “I use aerosol generating procedures less” 26%; and “Once immunized, I’ll work without fear” 6%. Dentists continued to work with fear of SARS-CoV-2; they had partially applied enhanced infection control procedures. They perceived a need for infection control education. Infection control education and training needs remain to be addressed to make dental clinics safer for providers and their patients.

Extending health systems resilience into communities: a qualitative study with community-based actors providing health services during the COVID-19 pandemic in the Philippines

BackgroundAmidst ongoing calls for increased health systems resilience, gaps remain in our understanding of how health systems can reach further into communities to ensure resilient service delivery. Indeed, public health emergencies caused by infectious hazards reveal both the value and vulnerability of the workforce delivering health services in communities. This study explores ways in which a non-governmental organization (NGO) in the Philippines protected their frontline workforce during the first year of the COVID-19 pandemic.MethodsGuided by a qualitative descriptive approach, 34 in-depth interviews were conducted with community-based health actors employed by the NGO between June 2020 and February 2021. Data analysis was guided by an iterative deductive and inductive approach.ResultsWe identified four key activities that enabled the NGO and their staff to provide health and social services in communities in a safe and consistent manner as part of the organization’s pandemic response. These include (1) ensuring adequate personal protective equipment (PPE) and hygiene supplies; (2) providing contextualized and role-specific infection prevention and control (IPC) training; (3) ensuring access to testing for all staff; and (4) providing support during quarantine or isolation.ConclusionLearning from the implementation of these activities offers a way forward toward health emergency preparedness and response that is crucially needed for NGOs to safely leverage their workforce during pandemics. Further, we describe how community-based health actors employed by NGOs can contribute to broader health systems resilience in the context of health emergency preparedness and response.

Healthcare Workers' Perception of Measures to Reduce the Risk of New Tuberculosis Infections: A Qualitative Study Report.

Tuberculosis, which is an infectious airborne disease remained the main leading cause of death in South Africa for three consecutive years from 2016 to 2018. In 2020 alone, the country had an estimated 328,000 people who suffered from TB, with 61,000 dying from it. Collins Chabane Municipality had 129 and 192 new TB cases recorded in 2017 and 2018, respectively, which is far from reaching the END TB STRATEGY targets. WHO scientific evidence demonstrates that TB control measures are effective in reducing the spread and development of new cases. Though scientific evidence revealed negative attitudes towards the recommended TB control measures in public hospitals of the Vhembe district, a deeper understanding of these attitudes is needed to remedy the situation. This study aimed to describe healthcare workers' perceptions of TB control measures at Collins Chabane Municipality in South Africa. A qualitative, exploratory case study design was adopted. Multi-stage sampling technique was used to select both the healthcare facilities and the participants. Only 24 healthcare workers trained on tuberculosis management were voluntarily recruited. However, data were saturated at the twelfth (12) participant purposively selected from six healthcare facilities of Collins Chabane Municipality. Data collected through unstructured in-depth individual interviews were analyzed thematically. The proposal for this study was ethically cleared by the University of Venda Ethics Committee (SHS/20/PDC/35/1111). Results indicate that TB administrative, environmental and respiratory control measures are well understood by health workers even though there are challenges with implementation concerning some, such as closing windows during winter, UVGI lights that are non-functional and taking too long to be fixed, no specimen collection during weekends and holidays thereby delaying TB diagnosis and lack of skills concerning how to use respirators and cough etiquette. The Vhembe district TB control programme should intensify infection control training and continue monitoring giving the needed support.

Paramedics’ knowledge, attitudes, and practices regarding the use of personal protective equipment against COVID-19

The risk of novel coronavirus disease (COVID-19) transmission in the confined mobile ambulance compartment is increased during aerosol-generating procedures and close proximity. Paramedics are encouraged to increase body-surface-isolation by donning additional personal protective equipment (PPE) during patient encounters. This study aimed to better understand paramedics' knowledge, attitudes, and practices related to PPE use during the COVID-19 pandemic in the prehospital setting with a focus on mitigating risks associated with infection control. This prospective quantitative study collected descriptive data using a specifically designed data collection tool. The survey data was then cleaned and analyzed with Microsoft Excel® and the latest version of the Statistical Package for Social Sciences. One thousand frontline paramedics employed by the Hamad Medical Corporation Ambulance Service (HMCAS) were invited via email to participate in the study. A total of 282 (28.2% of frontline paramedics) paramedics completed the online survey, of which 80.1% completed the mandatory HMCAS online infection control training program within the last year, and 17.0% between one to two years ago. Approximately 83% of the participants had completed an N95 mask fit test at HMCAS within the past five years, and 91.5% completed the hand hygiene training. The study found that 98.2% of the paramedics were knowledgeable about COVID-19 and its transmission, while 96.1% agreed that aerosol-generating procedures increased airborne transmission. The paramedics' attitudes were mainly positive toward the use of PPE to prevent the spread of the virus, which was synchronous with their practice. The sample population demonstrated a strong knowledge of COVID-19 and its transmission. Their overall positive attitudes and good infection control practices were demonstrative of efforts to mitigate risks associated with the spread of the virus.

English care home staff morale and preparedness during the COVID pandemic: A longitudinal analysis

BackgroundStaff actions to prevent infection introduction and transmission in long-term care facilities (LTCFs) were key to reducing morbidity and mortality from COVID-19. Implementing infection control measures (ICMs) requires training, adherence and complex decision making while trying to deliver high quality care. We surveyed LTCF staff in England about their preparedness and morale at 3 timepoints during the COVID-19 epidemic. MethodsOnline structured survey targeted at LTCF workers (any role) administered at 3 timepoints (November 2020-January 2021; August-November 2021; March-May 2022). Narrative summary of answers, narrative and statistical summary (proportionality with Pearson's chi-square or Fisher's Exact Test) of possible differences in answers between waves. ResultsAcross all 3 survey waves, 387 responses were received. Morale, attitudes towards working environment and perception about colleague collaboration were mostly positive at all survey points. Infection control training was perceived as adequate. Staff felt mostly positive emotions at work. The working environment remained challenging. Masks were the single form of PPE most consistently used; eye protection the least used. Mask-wearing was linked to poorer communication and resident discomfort as well as mild negative health impacts on many staff, such as dehydration and adverse skin reactions. Hand sanitizer caused skin irritation. ConcusionsStaff morale and working practices were generally good even though the working environment provided many new challenges that did not exist pre-pandemic.