Factors preventing nosocomial outbreak following a single case of COVID-19 diagnosed during hospitalization: A retrospective review

Objective: Our hospital experienced a hospital shutdown and quarantine for two weeks after one case of COVID-19 was diagnosed during hospitalization. We analyzed the reopening process following hospital closure and possible factors that prevented hospital spread. Methods: We retrospectively reviewed the confirmed patient’s medical records and results of epidemiological survey available from the infection control team of our hospital. Results: A total of 117 hospital staff members were tested, 26 of whom were self-isolated. Of the 54 inpatients tested, 28 on the same floor and two close contacts in the endoscopic room were quarantined in a single room. Finally, all quarantined hospital staff, inpatients and outpatients were tested for COVID-19 on the 14th day of close contact. The results were all negative, and the hospital work completely resumed. Conclusion: Although closing and isolating the hospital appeared to have played a useful role in preventing the spread of COVID-19 inside the hospital and to the local community, it is still debated whether or not the duration of hospital closure or quarantine was appropriate. The lessons from the two-week hospital closure suggest that wearing a mask, hand hygiene and the ward environment are important factors in preventing nosocomial outbreaks of COVID-19.

Influences on Pregnant Women’s and Health Care Professionals’ Behaviour Regarding Maternal Vaccinations: A Qualitative Interview Study

The uptake of maternal influenza and pertussis vaccinations is often suboptimal. This study explores the factors influencing pregnant women’s and health care professionals’ (HCPs) behaviour regarding maternal vaccinations (MVs). Pregnant/recently pregnant women, midwives, pharmacists and general practice staff in Waikato, New Zealand, were interviewed. The analysis used the behaviour change wheel model. Interviews of 18 women and 35 HCPs revealed knowledge about MVs varied with knowledge deficiencies hindering the uptake, particularly for influenza vaccination. HCPs, especially midwives, were key in raising women’s awareness of MVs. Experience with vaccinating, hospital work (for midwives) and training increased HCPs’ knowledge and proactivity about MVs. A “woman’s choice” philosophy saw midwives typically encouraging women to seek information and make their own decision. Women’s decisions were generally based on knowledge, beliefs, HCPs’ emphasis and their perceived risk, with little apparent influence from friends, family, or online or promotional material. General practice’s concentration on children’s vaccination and minimal antenatal contact limited proactivity with MVs. Busyness and prioritisation appeared to affect HCPs’ proactivity. Multi-pronged interventions targeting HCPs and pregnant women and increasing MV access are needed. All HCPs seeing pregnant women should be well-informed about MVs, including how to identify and address women’s questions or concerns about MVs to optimise uptake.

How did nurses cope with the fast, comprehensive organisational changes at Danish hospital wards during the COVID-19 pandemic? An interview study based on nurses’ experiences

PurposeThe COVID-19 pandemic has influenced hospital work and healthcare workers all over the world. We explored how Danish nurses coped with the fast, comprehensive organisational changes in their workplace and identified barriers to and facilitators for organisations ensuring the best possible conditions for nurses to meet these challenges. The study focuses on the organisational setting and how it did or did not support the nurses in their work.MethodsA qualitative explorative design was used in interviewing 23 nurses who had worked at a COVID-19 ward in one of three hospitals. Data were collected in the summer of 2020, and the analysis was inspired by Paul Ricoeur’s theory of narratives and interpretation.ResultsThe presence of managers in the wards helped the nurses in the form of psychological and practical support. Working within an organisation that provides a safe environment was essential for nurses. The experience of a safe environment allowed nurses to ask questions, which supported them in finding solutions to specific tasks in the new and critical working environment. Barriers to handling the new situation were an absence of managers and a lack of a sense of belongingness and trust.ConclusionThis study highlights the need for management to be present in the ward and for organisational support to be available to nurses so they can provide optimal treatment and care when working in new and unknown conditions during a pandemic. Practical assistance from managers to ease the job is beneficial. Furthermore, the presence of management is essential to provide psychological support and create a safe environment because this allows nurses to ask questions about how to better manage new and critical tasks.

A qualidade da iluminação do ambiente de trabalho hospitalar como fator de desempenho de profissionais da saúde / The quality of lighting in the hospital work environment as a factor in the performance of health professionals

A iluminação artificial e natural de hospitais é fundamental para o correto desempenho da atividade laboral e recuperação dos pacientes. No ambiente hospitalar a questão da iluminação deve ser atendida adequadamente em todas as alas de atendimento, uma vez que a visualização auxilia no correto diagnóstico, procedimento cirúrgico, leitura e interpretação de resultados de análises laboratoriais e consequentemente de posologias medicamentosas. O presente estudo teve como objetivo analisar por meio da técnica de luminotécnica a adequação dos índices de iluminância de um hospital localizado no estado de Rondônia, o qual baseou-se na realização de visita in loco e avaliação dos índices de iluminância de diferentes setores hospitalar com o auxílio de um luxímetro. Em comparação com a norma NBR 8995:2013, que trata de valores para cada tipo de ambiente, podemos identificar pontos estudados fora dos valores ótimos estabelecidos pela norma vigente, sendo estes, o posto de enfermagem da ala de ortopedia, sala de triagem, atendimento odontológico e de dispensação de medicamentos. Contudo novas averiguações devem ser realizadas para que se tenha um fator conclusivo, pois existem algumas variáveis como clima, horário, a inativação de algumas lâmpadas, obstrução de janelas e as condições de manutenção e tempo de uso das luminárias que devem ser avaliadas e correlacionadas.

Focusing the Safety Spotlight: How Safety Intelligence Can Inform Systemic Patient Safety Initiatives

This panel discussion at the 2021 Human Factors and Ergonomics Society (HFES) Healthcare Symposium (HCS) touched upon several topics related to actioning safety intelligence to improve patient safety. The panel had representation from both Canada and England across a broad range of human factors expertise in healthcare: from the perspective of academic research, operational hospital work, patient safety incident investigation and national healthcare policy, and a nationwide healthcare liability insurer. The panelists began with defining safety intelligence and distinguishing between safety intelligence and safety wisdom. The panel provided an engaging and insightful discussion on several topics including data collection, analysis and actioning upon the insights gained. In addition, the panel discussed strategies for demonstrating value in improving patient safety, and emphasised the importance of aligning one’s work with existing initiatives in the organisation, as well as the importance of collaborating with various stakeholders across the system to affect meaningful change.

Automating Measurement of Trainee Work Hours

BACKGROUND: Medical training programs across the country are bound to a set of work hour regulations, generally monitored via self-report. OBJECTIVE: We developed a computational method to automate measurement of intern and resident work hours, which we validated against self-report. DESIGN, SETTING, AND PARTICIPANTS: We included all electronic health record (EHR) access log data between July 1, 2018, and June 30, 2019, for trainees enrolled in the internal medicine training program. We inferred the duration of continuous in-hospital work hours by linking EHR sessions that occurred within 5 hours as “on-campus” work and further accounted for “out-of-hospital” work which might be taking place at home. MAIN OUTCOMES AND MEASURES: We compared daily work hours estimated through the computational method with self-report and calculated the mean absolute error between the two groups. We used the computational method to estimate average weekly work hours across the rotation and the percentage of rotations where average work hours exceed the 80-hour workweek. RESULTS: The mean absolute error between self-reported and EHR-derived daily work hours for first- (PGY-1), second- (PGY-2), and third- (PGY-3) year trainees were 1.27, 1.51, and 1.51 hours, respectively. Using this computational method, we estimated average (SD) weekly work hours of 57.0 (21.7), 69.9 (12.2), and 64.1 (16.3) for PGY-1, PGY-2, and PGY-3 residents. CONCLUSION: EHR log data can be used to accurately approximate self-report of work hours, accounting for both in-hospital and out-of-hospital work. Automation will reduce trainees’ clerical work, improve consistency and comparability of data, and provide more complete and timely data that training programs need.

Attitude of dental interns, final year and third-year students towards their involvement in hospital work during COVID-19 pandemic in private dental colleges in Vidarbha, India

Background: because of the ongoing pandemic, dental education is severely affected. Even though as in every other field teachers have taken to virtual education, but in dentistry, no virtual lectures can even come close to the experience gained by students while practicing on patients. This study aims to evaluate student’s attitudes regarding their involvement in hospital work at the time of the ongoing COVID19 pandemic and how it might impact their confidence and preparedness in the future.Method: A validated questionnaire was circulated online among the students of five dental colleges of Vidarbha who have suspended all student activities on the campus of their college including internship. A total of 711 students responded.Result: out of 711 students 52.9% of students are highly motivated to work in the hospital. However 52.7% are afraid of getting infected by the COVID-19 virus while working in the hospital, and 78.6% are worried that their loved ones can get infected because of them. 62% of students feel that they are less prepared for next year as they have no learned substantially in the last 6 months.Conclusion: as the majority of students are highly motivated to work, private colleges should resume internships. This will benefit students as well as patients. Colleges should also consider calling in final year students in reduced batches, and allow them to assist or observe clinicians maintaining all precautionary protocols.

Correction to: Salutary factors and hospital work environments: a qualitative descriptive study of nurses in Sweden

An amendment to this paper has been published and can be accessed via the original article.

Pediatricians’ Attitudes Towards the Clinical Application of Blockchain Technology to Pediatric Health Care: A Questionnaire Survey (Preprint)

BACKGROUND Medical technology has made remarkable advances in various fields. With the development of health care technology, the quality of life and longevity of humans have improved. Interest in the exchange ofThis study attempts to clarify the thoughts and attitudes pediatricians towards introducing blockchain technology into the medical field. medical information is also increasing. OBJECTIVE This study attempts to clarify the thoughts and attitudes pediatricians towards introducing blockchain technology into the medical field. METHODS We conducted a questionnaire survey among Korean pediatricians working in different types of hospitals (primary, secondary, and tertiary). A paper questionnaire and a Google questionnaire form were used. RESULTS The score for the intention and expectation of using blockchain technology was 4.0 – 4.6. Pediatricians working at tertiary hospitals showed slightly more positive answers in terms of expectations and efforts to use blockchain technology. In terms of attitudes towards and perspectives about blockchain technology, pediatricians expressed only few positive opinions about the use of blockchain for hospital work (4.3 – 4.7), but those working at tertiary hospitals provided slightly more positive answers in terms of attitudes toward blockchain technology. However, pediatricians working in the primary and secondary hospitals expressed a slightly negative view towards applying blockchain technology to hospital work (p=0.018). CONCLUSIONS In the future, when introducing the medical records of related pediatric and adolescent patients with blockchain technology, it is recommended to conduct a pilot project that prioritizes pediatricians in tertiary hospitals. With regard to the introduction of blockchain technology to the medical industry, technology, cost, policy, and perceptions of market participants are important. Through this study, we investigated the perceptions of pediatricians, one of the market participants in the introduction of blockchain technology to the medical industry. It is hoped that the findings of this study will stimulate active discussions related to the introduction of blockchain technology in the field of pediatrics in the future. CLINICALTRIAL Blockchain; Personal Health information; Pediatrics; Tertiary Hospitals; Pediatricians