APA Briefly: Prevention policy

Background: Standard precautions prevent the spread of infections in healthcare settings. Incompliance with infection control guidelines of healthcare workers (HCWs) may increase their risk of exposure to infectious disease, especially under pandemics. The purpose of this study was to assess the level of compliance with the infection prevention and control practices among HCWs in different healthcare settings and its relationship with their views on workplace infection control measures during the COVID-19 pandemic. Methods: Nurses in Hong Kong were invited to respond to a cross-sectional online survey, in which their views on workplace infection and prevention policy, compliance with standard precautions and self-reported health during pandemics were collected. Results: The respondents were dissatisfied with workplace infection and prevention policy in terms of comprehensiveness (62%), clarity (64%), timeliness (63%), and transparency (60%). For the protective behavior, the respondents did not fully comply with the standard precautions when they were involved in medical care. Their compliance was relatively low when having proper patient handling (54%) and performing invasive procedures (46%). A multivariate analysis model proved that the level of compliance of the standard precautions was positively associated with the satisfaction on infection control and prevention policy among high risk group (0.020; 95% CI: 0.005–0.036), while older respondents had higher level of compliance among the inpatient and outpatient groups (coefficient range: 0.065–0.076). The higher level of compliance was also significantly associated with working in designated team and having chronic condition of the respondents among high-risk and inpatient groups. Conclusions: Standard precautions are the most important elements to reduce cross-transmission among HCWs and patients while the satisfaction on infection control and prevention policy would increase the compliance among the high-risk group. An overall suboptimal compliance and poor views on the infection prevention and control guidelines is a warning signal to healthcare system especially during pandemics.

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Severe COVID-19 with acute respiratory distress syndrome (ARDS) in a sickle cell disease adult patient: case report

BMC Pulmonary Medicine ◽

10.1186/s12890-021-01412-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Marion Teulier ◽

Alexandre Elabbadi ◽

Grigorios Gerotziafas ◽

François Lionnet ◽

Guillaume Voiriot ◽

...

Keyword(s):

Sickle Cell ◽

Case Reports ◽

Cor Pulmonale ◽

Point Of View ◽

Nasopharyngeal Swab ◽

Prevention Policy ◽

Cord Injury ◽

History Of ◽

Pulmonary Arterial ◽

Venovenous Ecmo

Abstract Background Sickle-cell anaemia is a widespread genetic disease prevalent worldwide among African and African-American populations. The pathogenesis is most often revealed by pulmonary conditions, including acute thoracic syndrome, which is affecting the life expectancy of these populations. The global spread of CoV2-SARS infection with a respiratory tropism, endothelial damages and procoagulant status endangers the SCD population. However, with only a few case reports, consequences of the Covid-19 pandemic on SCD population remain poorly known. Case presentation We report a case of a 33-year-old man with a history of homozygous SS homozygous sickle cell anemia who consulted on March 24, 2020 for febrile dyspnea 11 days after the onset of symptoms. A nasopharyngeal swab was positive for SARS-CoV-2. His respiratory status worsened rapidly in the emergency room and then in ICU leading to severe ARDS requiring intubation, curarization, and venovenous ECMO. Hematologically, severe hemolysis associated with major thrombocytopenia without documented spinal cord injury was noted. Several transfusion exchanges are performed. The evolution was finally slowly favorable and led to discharge from the intensive care unit and then from the hospital. Conclusions This case recalls the importance of an increased prevention policy against COVID-19among the SCD population. In addition, from a therapeutic point of view, it advocates (1) a high preventive anticoagulation from the outset according to the level of D-dimers (2) the use of venovenous ECMO in this particular case, whereas this technique has had rather disappointing results in acute chest syndromes. (3) Unexpectedly, our patient did not develop pulmonary arterial hypertension (PAH) and acute cor pulmonale (ACP), whereas this is a common feature of ARDS during SCD. These last two observations suggest a different pathophysiology of pulmonary disorders in SCD patients in the case of SARS COv2. It could be associated with marked hypoxemia secondary to pulmonary vascular vasodilation.

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Modernizing Perinatal Substance Use Management

Policy Politics & Nursing Practice ◽

10.1177/1527154420981945 ◽

2020 ◽

pp. 152715442098194

Author(s):

Brayden N. Kameg

Keyword(s):

Substance Use ◽

Pregnant Women ◽

Registered Nurses ◽

Treatment Strategies ◽

Analytical Framework ◽

Prevention Policy ◽

Opioid Use ◽

Health Crisis ◽

State Regulations ◽

Control And Prevention

The increase in prescription and illicit opioid use since 2000 has become an urgent public health crisis. While the opioid epidemic spans racial, regional, and socioeconomic divides, women have surfaced as one demographic affected by opioid use and related sequelae. Certain federal and state regulations, secondary to the Child Abuse Prevention and Treatment Act, strip pregnant women with opioid use disorders of the ability to engage autonomously with their health care clinician while simultaneously impeding their ability to achieve and sustain recovery. The purpose of this article is to explore current health policy that impacts pregnant women who use opioids. Recommendations to improve care, broadly, will be highlighted to include access to contraceptive services, universal screening for perinatal substance use, and access to appropriate treatment strategies. Policy modifications to facilitate these recommendations are discussed. The Centers for Disease Control and Prevention Policy Analytical Framework was utilized to derive recommendations. The recommendations are relevant to advanced practice registered nurses and midwives who have the potential to treat substance use in women, to women’s health and pediatric registered nurses, and to nursing administrators who are involved in decision-making in obstetric and pediatric settings.

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Services and surveillance during the pandemic lockdown: Residents’ committees in Wuhan and Beijing

China Information ◽

10.1177/0920203x211012822 ◽

2021 ◽

pp. 0920203X2110128

Author(s):

Zhenjie Yang ◽

Guilan Zhu ◽

Linda Chelan Li ◽

Yilong Sheng

Keyword(s):

Local Community ◽

Critical Role ◽

Control Measures ◽

Critical Periods ◽

Prevention Policy ◽

Grass Roots ◽

National Capital ◽

Prevention And Control Measures ◽

And Control ◽

Residents Committee

The COVID-19 pandemic caused a lockdown of Wuhan, and strict control was imposed in many major Chinese cities, including the national capital of Beijing. Residents’ committee workers at the grass-roots level have played a critical role in the enforcement of the government’s pandemic prevention and control measures, through their day-to-day service and surveillance as local community managers. This article examines their work in Wuhan and Beijing neighbourhoods during the most critical periods of the outbreak, from late January to June 2020, and the challenges the workers faced as executors of the government’s community-based prevention policy. The two cities have developed different community strategies because of very different epidemiological situations and city functions.

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