cord-007828-c7jxj74b	2014	Since the initial occurrence of Middle East respiratory syndrome coronavirus (MERS-CoV) in 2012, 1,2 the disease had caused 837 cases, with a case fatality rate of 34.7%. The World Health Organization (WHO) through its expert technical committees was prompt in developing its first infection control guidelines based on available knowledge on the new emerging virus, but it mostly drew on experience from a similar virus, severe acute respiratory syndrome coronavirus (SARS). Careful review of the recent increase in the number of cases revealed that about 25% were among HCWs. 4 Of the initial 128 recent MERS-CoV infected patients in Jeddah, Kingdom of Saudi Arabia, most (60%) were infected in the health care setting. Screening for Middle East respiratory syndrome coronavirus infection in hospital patients and their healthcare worker and family contacts: a prospective descriptive study Middle East respiratory syndrome coronavirus: a case-control study of hospitalized patients
cord-009114-mdlthnnp	2012	The Centers for Disease Control and Prevention recommends administrative measures, respiratory protection, and engineering (or environmental) controls for preventing the transmission of tuberculosis, the prototypical airborne infection, in health care settings. We propose that anterooms are key components of infection prevention and control and must always be considered in the design and operation of AIIRs in the setting of health care delivery. American Society of Heating, Refrigerating and Air Conditioning Engineers guidance states "[an] anteroom is not required [but] some isolation rooms may be provided with a separate anteroom," 16 whereas the Centers for Disease Control and Prevention/Healthcare Infection Control Practices Advisory Committee guidelines state "AII rooms can be constructed either with or without an anteroom." 17 One instance when anterooms are recognized as essential by most of these organizations is when combination airborne isolation and protective environment rooms are used to house infected patients with dysfunctional immune systems.
cord-009169-hzxgi1t0	2016	Investigations revealed a severe nosocomial infection resulting in deaths attributed to negligence by staff with poor infection prevention and control standards. Second, the under-reporting of nosocomial infection and the number of full-time staff experienced in infection control have been highlighted by health administrators during the performance appraisal of health care institutions. Failure to comply with standard regulations of hand hygiene or even handwashing after examining patients with infections, lack of standardized or complete disinfection of surgical instruments, failure to implement surgical standards, failure to consider oxygen humidifiers as an important source of lower respiratory infection, and inappropriate measures of disinfection and isolation are some of the factors that artificially increase nosocomial infection. • To improve environmental hygiene, a national system of sanitation should be created to provide population access to adequate sanitation measures given the current unsanitary conditions in hospitals sustainable care and development and nosocomial infection management.
cord-034660-g28qmyh8	2020	Since its first call with a COVID-19 patient ("case") on March 27, the Contact Tracing program at Penn State Health, previously described in this journal 1 , has completed calls with 87% of all cases. In New York City, only 42% of people with COVID-19 gave information about close contacts to tracers 3 , whereas Penn State Health''s success rate in this regard is 62.5% since its inception. Hi, this is _____ calling from Penn State Health (Designed to incorporate the tactics of conveying expertise and trustworthiness of a health care provider and University, on the one hand, which increases a communicator''s influence and enhancing feelings of unity of place, on the other, which increases survey participation 4 ). We would also like to talk to you about your own quarantining measures and ways that we may be able to help (Designed to incorporate the tactic of reciprocity, in which people feel obligated to help to those who seek to help them and their close others 8 ).
cord-253240-rtv136j7	2013	CONCLUSION: SVPCR array RP testing detected respiratory pathogens in pediatric patients with URI at rates higher than that of RAT and viral culture. The study hypothesis is that the use of combined isolation precautions should be continued, even after the H1N1 pandemic, in pediatric patients with URI symptoms based on the detection of pathogen coinfections by use of a small volume polymerase chain reaction (SVPCR) array respiratory panel (RP) that requires both droplet and contact isolation precautions. From January through April and again from September through December 2010 (no samples were collected May-August), pediatric patients (up to age 20 years) presenting to the emergency department (ED) at CHM, a tertiary pediatric medical center in Detroit, Michigan, were offered participation in the study if the treating clinician had ordered any testing for viral respiratory pathogens.
cord-253487-gl5lozn9	2019	[8] [9] [10] A review of the hand hygiene monitoring throughout 1 organization found the data that were based on observation of practice did not accurately reflect infection control compliance, 11 contributed little to improving practice, were not considered the best use of time, and lacked local credibility. The Infection Control Continuous Quality Improvement (IC-CQI) tool was developed in an acute teaching hospital in London, with over 1,200 inpatient beds and 8,000 staff spread across 7 hospitals on separate sites, providing emergency, general medicine, surgery, critical care, maternity, neonatal, and cancer services. To create an IC-CQI tool and reporting framework the infection prevention team used the Pronovost Knowledge Translation Cycle 17 to review the current hand hygiene monitoring tool, and to develop a quality improvement data collection tool. Intermittent validation was then undertaken of IC-CQI results including hand hygiene product availability, isolation practices, appropriateness of use of personal protective equipment (PPE), and compliance with standards of invasive devices insertion and management throughout the implementation period.
cord-257595-l8bsoqbx	2020	BACKGROUND: Since Vitamin D is known to be vital in regulating the immune system, and sunlight UV radiation exposure on the skin produces Vitamin D and UV intensity is highest nearest the equator, a study was done to examine the correlation between the latitude and COVID-19 fatality rates for countries. This study is the first to document a statistically significant correlation between a country''s latitude and its COVID-19 mortality and is consistent with other research regarding latitude, Vitamin D deficiency, and COVID-19 fatalities. Because of the positive correlation between sunlight UV radiation and healthy Vitamin D levels in the body, and reported positive correlation between Vitamin D deficiency and fatality rates to COVID-19, the present study examined the relationship between a country''s proximity to the equator and its death rates from the current pandemic.
cord-259279-8dspud40	2020	Test results demonstrated that the double layer isolation gown configuration does not always provide equal fluid resistance as the higher level of isolation gown according to results from the AATCC 42 and AATCC 127 standard test methods, which are described in ANSI/AAMI PB70. Three commonly used (labeled as A, B, and C) ANSI/AAMI Level 2 isolation gown models were selected and tested in single layer and double layer configurations in accordance with ANSI/AAMI PB70 requirements. Three ANSI/AAMI Level 2 isolation gown models (A, B, C) were tested in single layer and double layer configurations using two water resistance test methods; AATCC 42, and AATCC 127, which were previously defined. According to the AATCC 42 impact penetration results, fluid resistance of A, B, and C continuous region samples was increased about 89%, 97%, and 91%, respectively, when comparing single versus double layer configuration.
cord-259338-q3kw6n9o	2020	We aimed to create a prototype staff surveillance system for the detection of acute respiratory infection (ARI) clusters amongst our healthcare workers (HCWs) and describe its effectiveness. Conclusion The use of syndromic surveillance to detect ARI clusters amongst HCWs in the COVID-19 pandemic may enable early case detection and prevent onward transmission. Utilizing the electronic health records, we have created a prototypic surveillance system in the detection of acute respiratory infection (ARI) clusters amongst staff and aim to describe its effectiveness in this study. The aim of this descriptive analytic study is to describe the effectiveness of a prototypic staff syndromic surveillance system in identifying acute respiratory infection (ARI) clusters amongst the staff population in the hospital. This initial feasibility study shows that the use of a syndromic surveillance system has the ability to identify ARI clusters amongst staff populations that would initiate downstream investigation and active screening.
cord-259461-ig9g1o8b	2020	This study''s aim was to discern the nursing organizational culture and job stress, induced by infection control nurses (ICNs)'' working together, affects ICNs'' turnover intentions. 8 This study aimed to understand the nursing organizational culture and job stress created by ICNs working together, affected turnover intention, and the general characteristics influencing it. In Step 1 of the turnover intention regression model, job stress was selected as a significant variable in previous studies 4, 7 and each type of nursing organizational culture 6, 7, 8 These correlations were similar to those in general nursing organizations, 8, 9 and the results were the same as those in a preceding study in that relation-oriented organizational culture was the main influential factor that significantly affected turnover intention. The results are expected to help infection-control organizations manage staffing in a stable and efficient manner by lowering ICNs'' turnover intention, allowing ICNs to manage their job stress and establish a relation-oriented organizational culture.
cord-259639-j7pmb3mk	2020	title: Evaluation of an Electrostatic Spray Disinfectant Technology for Rapid Decontamination of Portable Equipment and Large Open Areas in the Era of SARS-CoV-2 After minimal manual pre-cleaning of areas with visible soiling, application of a dilute sodium hypochlorite disinfectant using an electrostatic sprayer provided rapid and effective decontamination and eliminated the benign virus bacteriophage MS2 from inoculated surfaces. We examined the effectiveness of the spray application of disinfectant on wheelchairs (N=30), portable medical equipment (N=40 devices), and patient waiting area chairs (N=30). Application of a dilute sodium hypochlorite disinfectant using an electrostatic sprayer provided a rapid and effective means to reduce bacterial contamination on these surfaces and to eliminate an inoculated bacteriophage. In summary, our results suggest that application of a dilute sodium hypochlorite disinfectant using an electrostatic sprayer could provide rapid and effective decontamination of portable equipment and large open areas.
cord-261595-c69vfs8q	2008	RESULTS: Religious faith and culture can strongly influence hand hygiene behavior in health care workers and potentially affect compliance with best practices. The Task Force was created to explore the potential influence of transcultural and religious factors on attitudes toward hand hygiene practices among health care workers and to identify some possible solutions for integrating these into strategies for improving hand hygiene. Of the remaining articles, only 27 referred to cultural and/or religious aspects influencing health, in particular hygiene, hand hygiene practices, and alcohol prohibition according to the most important religions; these were retained for review. Otherwise, rubbing the hands with an alcohol-based formulation is recommended as the preferred practice for all other hand hygiene indications during patient care, because it is faster, more effective, and better tolerated by the skin.
cord-261736-jlwctmxw	2016	The aim of this study was to qualify and quantify bioaerosol concentrations during bronchoscopy to evaluate the occupational risk to HCWs. Knowing the real exposure is essential to encouraging HCWs to implement better prevention protocols and wear personal protective equipment if needed. The average concentrations (colony forming units/meters 3 of air) and the standard deviations of the culturable bacteria measured in the 2 bronchoscopy rooms are presented in Table 1 . To our knowledge, this is the first study to measure and identify the actual bacterial flora present in the ambient air of a room while bronchoscopies are being performed on patients. The identification of Streptococcus pneumoniae, Neisseria sp, and Corynebacterium sp shows that culturable bacteria from oral, nasal, and pulmonary flora were present in the air of the rooms during bronchoscopy procedures. It provides clear evidence of the presence of culturable opportunistic bacteria originating from the respiratory tract of patients in the air of bronchoscopy rooms.
cord-264972-hrbo3awj	2016	title: Evaluating the impact of the multiplex respiratory virus panel polymerase chain reaction test on the clinical management of suspected respiratory viral infections in adult patients in a hospital setting A retrospective cohort design was used to study the impact of a multiplex respiratory virus panel polymerase chain reaction test in 186 adult patients with suspected influenza-like illness. The objective of our study was to evaluate the impact of the MRVP test on the use of antiviral and antimicrobial therapy among adult patients in a hospital setting (either emergency room or inpatients) with suspected influenza-like illness. We evaluated whether the MRVP test result was associated with the changes in management in antiviral and antibiotic treatment (see the definition in Supplementary Appendix S1), after stratifying by patient location. We conclude that the MRVP test could potentially positively impact the clinical management of respiratory viral infections in adult patients.
cord-266667-6isk8jgj	2019	BACKGROUND: Little is known about health care workers'' (HCW) perceptions of, or experiences using, respiratory protective equipment (RPE). RESULTS: We identified 5 story types surrounding RPE use: 1) policies are known and seen during work routines; 2) during protocol lapses, use is reinforced through social norms; 3) clinical experiences sometimes supersede protocol adherence; 4) when risk perception is high, we found concern regarding accessing RPE; and 5) HCWs in emergency departments were viewed as not following protocol because risk was ever-present. HCW adherence to respiratory infection control guidelines, including vaccinations, are known to be influenced by personal and contextual factors, such as knowledge gaps, perceived risk, ethical and legal concerns, and economic issues 9, 10 Health behavior theories, such as the Health Belief Model, 11 have been used to examine adoption of health-related behaviors.
cord-267860-mc0xa5om	2016	This study, hence, aimed to examine the sensitivity, specificity, predictive values, and likelihood ratios of the user seal check on actual gross leakage detection during normal breath-ing or deep breathing without head and body movement in 3 common respirator models of different designs. The results of the user seal check compared with the gold standard QNFT on actual gross leakage through cross tabulation were used to compute the following diagnostic parameters: sensitivity, specificity, positive and negative predictive values, and likelihood ratios (refer to the "NOTE" in Table 4 for the respective formula). To illustrate the clinical implication of the current results of predictive values and likelihood ratios, by using an example of donning the 3M-A respirator, an interpretative summary of the validity and test performance of the user seal check for identifying actual gross leakage is presented as follows.
cord-270909-wb7mwklo	2020	BACKGROUND: To describe the infection control strategy to achieve zero nosocomial transmission of symptomatic coronavirus disease (COVID-19) due to SARS-CoV-2 during the pre-pandemic phase (the first 72 days after announcement of pneumonia cases in Wuhan) in Hong Kong. Pandemic infection of a coronavirus disease 2019 (COVID-19) due to severe acute respiratory syndrome-associated coronavirus-2 (SARS-CoV-2) was declared by World Health Organization (WHO) on 11 March 2020, which is 72 days after announcement of a cluster of patients with community acquired pneumonia in Wuhan, Hubei Province by National Health Commission of the People''s Republic of China (NHCPRC), on 31 December 2019 (day 1) [1] . Up to 11 March 2020 (day 72 after the official announcement of a cluster of pneumonia of unknown etiology in Wuhan, Hubei Province, a total of 130 cases of SARS-CoV-2 infection were confirmed in Hong Kong, while the first 42 patients were reported previously [9] .
cord-271187-rlevoj41	2020	A cross-sectional serological survey was carried out in two long term care facilities that experienced COVID-19 outbreaks in order to evaluate current clinical COVID-19 case definitions. Serological testing may be useful to evaluate and inform public health infection control practices by uncovering cases missed during an outbreak using current laboratory-based and clinical case definitions. Our analysis aims to provide a descriptive overview of a serological survey of LTC residents and staff members following outbreaks at two facilities and evaluate clinical case definitions of COVID-19 used in LTC outbreaks against serological results. Clinical information (symptomatic/asymptomatic history, symptoms recorded, medical comorbidities, medications) for each individual was gathered by abstracting data from a standardized case report form (Appendix C), medical charts of LTC residents, and phone interviews. however, no studies to date have used serology to inform clinical case definitions and subsequently infection control measures in LTC facilities.
cord-273531-q9ah287w	2020	Background: This study described and analyzed the age, gender, infection sources, and timing characteristics of the 416 confirmed cases in two cities near the center of China''s COVID-19 outbreak. Methods: This study used publicly available data to examine gender, age, source of infection, date returned from Hubei, date of disease onset, date of first medical visit, date of final diagnosis, and date of recovery of COVID-19 cases. Results: Public-use data revealed similar risks of infection by age and that the numbers of new and final diagnoses of confirmed cases first increased, peaked at about two weeks, and then gradually decreased. The first novel coronavirus pneumonia (COVID19) case was identified in Wuhan, Hubei Province, China, on December 12, 2019, after which the disease gradually spread. The variables used in the analysis were: gender, age, source of infection, date returned from Hubei, date of disease onset, date of first medical visit, date of final diagnosis, and date of recovery.
cord-273604-0w5shxmf	2020	Faced with a dwindling supply of PPE, the Infection Control team distributed supplies saved for a possible Ebola outbreak; A COVID unit was created within the nursing home facilitating the geographic isolation of cases; universal testing of residents and employees allowed for the implementation of proper quarantine measures. 7 Although nationally the virus spreads like wildfire in nursing homes (among residents and working staff), the Department of Veterans Affairs (VA) reported lower COVID-19 rates in their affiliated nursing homes in a U.S. Congressional hearing. Swift detection by rapid RT-PCR testing of all asymptomatic carriers (residents and employees via universal testing) and implementation of strict infection control and isolation measures are pivotal in containing and thus eliminating a COVID-19 outbreak. Universal and Serial Laboratory Testing for SARS-CoV-2 at a Long-Term Care Skilled Nursing Facility for Veterans Hospital affiliated long term care facility COVID-19 containment strategy by using prevalence testing and infection control practices
cord-273748-xy4f5kon	2020	To overcome this challenge, stringent policies and appropriate use of PPE, such as face shields, safety glasses, and N95 masks, are indicated for providers performing aerosol-generating procedures [7] . In response to the COVID-19 Pandemic, The University of Nebraska Medical Center (UNMC), Department of Anesthesiology, mandated that anesthesia providers use face shields during patient care to extend the life of N95 masks and adequately protect providers from infection with SARS-CoV-2. Given this information, we developed a decontamination protocol that utilized a dilute bleach solution that would allow penetration into any of the pores that are generated in the 3D printing process and permit the reuse of the face shields. After careful consideration, we chose to use a Prusa i3 MK3S model printer for our 3D face shield printing needs. As a positive control, organism suspensions were inoculated to each face shield part, allowed to dry, and swabbed without decontamination.
cord-275552-ijxxeo27	2007	The objective of this study was to estimate the median amount of money ED personnel would be willing to pay for preventing nosocomial severe acute respiratory syndrome (SARS). 9 In this study, CVM was used to estimate the median amount emergency medical personnel would be willing to pay for a hypothetical vaccine to prevent developing nosocomial SARS. We used this study as an example to demonstrate that medical personnel would be willing to pay substantial monetary amounts to avert the risk of nosocomial SARS infection. However, we found that the median amount medical personnel in the ED would be willing to pay for a SARS vaccine was US $1,762, which was exceedingly high compared to the usual cost of a vaccine and equal to 14% of the 2002 Taiwan gross domestic product per capita (US $12,588).
cord-275997-4ibeidyw	2005	In keeping with its philosophy of quality health care and responsible public reporting, the Association of Professionals in Infection Control and Epidemiology, Inc, continues to explore the issue of mandatory reporting of HAIs. The practice of infection control and applied epidemiology: A historical perspective Barbara A. In addition, the current trend toward mandatory reporting of health care-associated infections (HAIs) among several states will add more tasks for ICPs with limited resources, at the risk of spending less time on prevention and control activities. In addition, the current trend toward mandatory reporting of health care-associated infections (HAIs) among several states will add more tasks for ICPs with limited resources, at the risk of spending less time on prevention and control activities. Ninety-five tasks identified in the 1992 PA were organized into 5 major practice dimensions describing the responsibilities of ICPs in the United States and Canada: infectious process, surveillance/epidemiologic investigation, transmission of infection, management and communication, and education 14 (Table 1) ; however, new tasks were added, and outdated tasks were eliminated.
cord-276758-k2imddzr	2007	Activities currently assigned to ICPs in response to emerging challenges include (1) surveillance and infection prevention at facilities other than acute care hospitals (eg, ambulatory clinics, day surgery centers, LTCFs, rehabilitation centers, home care); (2) oversight of employee health services related to infection prevention (eg, assessment of risk and administration of recommended treatment after exposure to infectious agents, tuberculosis screening, influenza vaccination, respiratory protection fit testing, and administration of other vaccines as indicated, such as smallpox vaccine in 2003); (3) preparedness planning for annual influenza outbreaks, pandemic influenza, SARS, and bioweapons attacks; (4) adherence monitoring for selected infection control practices; (5) oversight of risk assessment and implementation of prevention measures associated with construction and renovation; (6) prevention of transmission of MDROs; (7) evaluation of new medical products that could be associated with increased infection risk (eg, intravenous infusion materials); (8) communication with the public, facility staff, and state and local health departments concerning infection control-related issues; and (9) participation in local and multicenter research projects.
cord-278592-67y4f9av	2008	To eradicate a hospital-wide outbreak, a coordinated strategy between March and June 2005 comprised (1) formation of a VRE task force, (2) hospital-wide screening, (3) isolation of carriers, (4) physical segregation of contacts, (5) surveillance of high-risk groups, (6) increased cleaning, (7) electronic tagging of VRE status, and (8) education and audits. 1 In 2004, a localized VRE outbreak in a hematology ward of Singapore General Hospital (SGH) involving 6 inpatients was blamed on overseas importation of the index case with breaches in infection control measures, resulting in subsequent dissemination in that ward. Patients with high-risk acquisition for VRE-like end-stage renal failure (ESRF) on dialysis, those with hematologic or oncologic malignancies, those transferred from other local or overseas hospitals, or those with hospital admissions after January 1, 2005 were defined as ''''unknowns.'''' Records of ''''contacts'''' and ''''unknowns'''' were electronically tagged to facilitate VRE screening by stool or rectal swab on 2 separate occasions at least 24 hours apart.
cord-279640-n391v32y	2008	The increased adoption of EHRs and related Health IT provide a unique opportunity for ICPs and infection diseases specialists to automate manual processes and address the growing challenge of HAI and guidelines for public reporting. 7 Order management, clinical decision support, patient support, and population health functions have the potential for a more direct impact on infectious disease management, surveillance, prevention, and control but are not generally essential components of all present day EHRs. Order management includes functions such as computerized physician order entry (CPOE), which allows electronic entry of laboratory, medications, and radiology orders instead of orders being recorded on paper sheets or prescription pads. Although the benefits of health information, result management, electronic connectivity, and administrative support activities in terms of 24/7 chart access and better availability of the data are apparent and well understood, CPOE and CDS when customized and utilized appropriately can also have a direct and significant impact on patient care.
cord-282272-wy8do2z6	2020	title: Environmental Detection of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) from Medical Equipment in Long-Term Care Facilities undergoing COVID-19 Outbreaks We conducted environmental sampling at long-term care facilities to determine the extent of surface contamination with SARS-CoV-2 virus. We conducted environmental sampling at long-term care facilities to determine the extent of surface contamination with SARS-CoV-2 virus. 2, 3 We conducted environmental sampling to assess the extent of surface contamination with SARS-CoV-2 virus within long-term care facilities with declared COVID-19 outbreaks. Environmental contamination with SARS-CoV-2 virus was detected at each of three COVID-19 outbreak facilities sampled in this study, including surfaces of five frequently used medical devices transferred between patient rooms, and one high-touch surface used by care staff This study contains limitations. Our findings suggest medical equipment is a potential environmental route for transmission of SARS-CoV-2 virus in long-term care facilities.
cord-285849-jg43tcfh	2004	title: Universal SARS preventive measures in an obstetrics unit: Experience of health care staff METHOD: Four weeks after implementation of universal precautionary measures at a teaching hospital in Hong Kong, a survey of the health care staff was conducted to identify their feelings and opinions. RESULTS: In spite of general knowledge about SARS epidemics and related mortality, most respondents stated that universal precautionary measures were not very necessary, especially in the obstetrics ward. CONCLUSION: Our findings reported the views and satisfaction levels of the front-line staff of an obstetric unit concerning precautionary measures against SARS. Universal precautionary measures were believed to be necessary, especially in certain high-risk areas such as obstetrics wards, where contact with body fluid is common. Medical staff (obstetricians), nursing staff, medical students, and supporting staff working in the labor ward and the obstetrics operating theater were asked about the necessity for and their satisfaction with each of the universal precautionary measures.
cord-288589-bt9429bh	2013	However, since November 2012, Saudi Arabia has also hosted a new fatal viral infection: the Middle East respiratory syndrome coronavirus (MERS-CoV). The first known occurrence of MERS-CoV in human was reported in a patient with severe acute respiratory infection in April 2012, in Jordan. There are many reasons to convince us that MERS-CoV represents a high risk: a deadly virus that can be transmitted from person to person, a mass gathering of millions of people from different parts of the world at the epicenter of the infection, an incubation period that provides enough time for pilgrims to return home and disseminate the virus, ceremonies that place relatives and friends in close contact with infected individuals when they return, and signs and symptoms that can easily be mistaken for common postpilgrimage flu-like syndromes. Clinical features and viral diagnosis of two cases of infection with Middle East respiratory syndrome coronavirus: a report of nosocomial transmission Middle East respiratory syndrome coronavirus (MERS-CoV), update
cord-290257-2u228xe9	2006	title: Confidence in controlling a SARS outbreak: Experiences of public health nurses in managing home quarantine measures in Taiwan This paper assesses factors related to public health nurses'' confidence in managing community SARS control programs. The third section contained questions (using 10-point Likert scale: 1 5 the worst to 10 5 the best) about the effectiveness of the nurse''s institution in managing the SARS epidemic, including the nurse''s assessment of (1) the institutional functioning on community home quarantine, (2) the quality of training received for controlling infectious disease outbreaks, and (3) the adequacy of support (for both manpower and financing) received from superior health agencies force commander said the epidemic situation was stable and advised people to return to their routine. In summary, public health nurses'' confidence in the control of a SARS outbreak and people''s compliance with quarantine measures are 2 major factors that can affect the success of a SARS-control program.
cord-290441-r4tzodkj	2020	CONCLUSIONS: HHC of doctors and nurses can be significantly improved with light-guided nudging and data-driven performance feedback using an automated hand hygiene system.  Doctors (surgeons) have lower baseline hand hygiene compliance than nurses  Light-guided nudging and data-driven performance feedback improve compliance  Individual performance feedback might be more effective than group feedback  The Sani nudge system detects more opportunities than using manual observations  Nurses and doctors disinfect hands more often after rather than before patient contact Background Evidence-based practices to increase hand hygiene compliance (HHC) among healthcare workers are warranted. HHC of doctors and nurses can be significantly improved with light-guided nudging and data-driven performance feedback using an automated hand hygiene system. Light-guided nudging and data-driven performance feedback improve hand hygiene compliance among nurses and doctors BACKGROUND Hospital-acquired infections (HAIs) continue to burden patients, healthcare workers (HCWs) and society by increasing morbidity, mortality, absenteeism and treatment costs (1-3).
cord-290961-wbdfcaup	2020	This study aimed to compare the accuracy of non-contact infrared thermometers (NCIT) with temporal artery thermometers (TAT) in an adult hospital. RESULTS: In 265 patients, a mean difference of ±0.26°C was recorded between the NCIT (36.64°C) and the reference TAT (36.90°C) temperature devices. In children, a 0.2-0.4°C mean difference in body temperatures at or above 37.5°C was reported between the NCIT temperature when measured at forehead as compared to the core temperature measurements conducted using Temporal Artery Thermometers (TATs) 8, 9 . Characteristics of the patients'' age, gender, skin colour, anti-pyretic medication use and highest temperature in the last 24 hours are assessed to determine their influence on body temperature measurement. Frequency distributions and mean (standard deviations) were calculated for characteristics of age, gender, skin colour, highest temperature and the anti-pyretic medication used in the last 24 hours, and body temperature recordings using the two devices.
cord-291650-1qy6y7f0	2016	title: Infection control and prevention practices implemented to reduce transmission risk of Middle East respiratory syndrome-coronavirus in a tertiary care institution in Saudi Arabia A-IC measures include administrative support with daily rounds; infection control risk assessment; timely screening, isolation, and specimen analysis; collaboration; epidemic planning; stockpiling; implementation of contingency plans; full personal protective equipment use for advanced airway management; use of a real-time electronic isolation flagging system; infection prevention and control team on-call protocols; pretransfer MERS-CoV testing; and education. Areas of deficiencies addressed at the organization level include insufficient number of staff in highrisk areas, fit testing for high-efficiency particulate respirators (especially for ED, ICU, and direct patient care providers), overcrowding in the ED, ventilation systems in the ED, extended turnaround time of MERS-CoV test results, and awareness of the importance of early identification and isolation of suspected cases.
cord-291679-jfxqipt8	2017	The aim of this study was to determine whether risk perception was associated with personal and social variables, including trust in the media, the health care field, and government. Additionally, we sought to identify the associations of risk perception and social variables with compliance with self-quarantine guidelines and overreaction during the MERS epidemic. In this study, knowledge, trust, personal characteristics, and other social determinants were considered the main factors affecting risk perception and overreaction. Therefore, this section assessed the following personal characteristics: degree of optimism about the health policies of South Korea, willingness to sacrifice for society, responsiveness to an emergency situation, and attitude toward self-quarantine and overreaction. To assess the associations of demographic factors, knowledge, trust in social organizations, intention to sacrifice, and responsiveness to emergency situations with risk perception, multiple linear regression analyses were used.
cord-291742-donflx7w	2018	We joined the Johns Hopkins Armstrong Institute Comprehensive Unit-Based Safety Program for Mechanically Ventilated Patients and Ventilator-Associated Pneumonia (CUSP 4 MVP-VAP) project in October 2015 with the objective of improving the care delivery process and reducing the mortality of our mechanically ventilated patients. The implementation of each care process bundle element, along with the Confusion Assessment Method for the ICU (CAM-ICU) score and the maximum level of mobility for that day were recorded on a standard data collection form and entered into the Johns Hopkins Armstrong Institute database, which generated a compliance rate for our hospital. In our study the implementation of the multifaceted CUSP 4-MVP VAP approach resulted in an increase in SAT (51.5%-76.9%, P = .0008) and SBT (54.2%-72.2%, P = .02) compliance; an increase in the number of mechanically ventilated patients without sedation (36.1%-50.9%, P = .06); and a decrease in IVACs (4.2-3.5 per 1,000 MV days), PVAP (2.1-1.7 per 1,000 MV days), ICU mortality rates (45.3%-19.1%, P = .045), and VAE mortality rates (33.3%-8.3%, P < .37).
cord-292981-7qbi7wqr	2010	Although UV light is known to inactivate microorganisms, limiting their ability to grow and multiply when inhaled or picked up on surfaces, there is insufficient evidence on which to base a decision to rely solely on UVGI as an engineering control for preventing health care-associated tuberculosis (TB) transmission. They concluded that ''''provided there is adequate mixing of room air, an upper-room UVGI fixture is an effective, low-cost intervention for use in TB infection control in high-risk clinical settings.'''' 35 5 Methods for determining whether existing room air mixing is sufficient for UVGI effectiveness are needed, and research should explore whether the use of mixing fans has a negative impact on the intended design of the mechanical ventilation systems or a negative impact on other infection control measures.
cord-295469-5an7836u	2016	The following groups of human pathogens are covered because of their known or potential airborne spread: vegetative bacteria (staphylococci and legionellae), fungi (Aspergillus, Penicillium, and Cladosporium spp and Stachybotrys chartarum), enteric viruses (noroand rotaviruses), respiratory viruses (influenza and coronaviruses), mycobacteria (tuberculous and nontuberculous), and bacterial spore formers (Clostridium difficile and Bacillus anthracis). The following groups of human pathogens are covered because of their known or potential airborne spread: vegetative bacteria (staphylococci and legionellae), fungi (Aspergillus, Penicillium, and Cladosporium spp and Stachybotrys chartarum), enteric viruses (noro-and rotaviruses), respiratory viruses (influenza and coronaviruses), mycobacteria (tuberculous and nontuberculous), and bacterial spore formers (Clostridium difficile and Bacillus anthracis). 71 Based on our considerable experience in the study of airborne human pathogens, 13, 25, 39, 43, 72 we have built an aerobiology chamber (Fig 2) designed to meet the requirements of the EPA guidelines and have used this to study the effects that a variety of air decontamination technologies have on the airborne survival and inactivation of vegetative bacteria, viruses (bacteriophage), and bacterial spore-formers (Sattar et al, unpublished data) .
cord-295733-f3rt1fyk	2020	When compared with previous study, more places that could be potentially contaminated by COVID-19 patients were sampled for viral RNA detection, such as the flush button of the toilet bowl, medical refuse transfer trolley, elevators, and the examination rooms for these patients. These areas could not be used for non-COVID-19 patients until all the environmental samples collected were negative for SARS-CoV-2 RNA detection. In this study, surface samples collected from the examination rooms were all negative for SARS-CoV-2 RNA detection, and the samples collected from isolation wards and other places were also negative for viral RNA detection, which indicated that the terminal disinfection was effective. Other researches had revealed the presence of SARS-CoV-2 RNA in aerosol, which indicated the air could be contaminated by the virus, and patients could be infected in the isolation wards [12, 28] . Detection of air and surface contamination by SARS-CoV-2 in hospital rooms of infected patients
cord-297462-c5hafan8	2018	METHOD: This study examined how the public discussed measles during the measles outbreak in the United States during early 2015 that originated in Disneyland Park in Anaheim, CA, through a semantic network analysis of the content of around 1 million tweets using KH coder. 3 This study adds to the research on crisis and emergency risk communication by demonstrating that social media users applied different frames to understand the public health crisis associated with a measles outbreak: news update frame, public health frame, vaccination frame, and political frame. Practically, the findings of the study allow public health professionals to understand how social media users make sense of an EID during different stages of the outbreak so that they can develop more effective crisis communication strategies.
cord-299475-p6cc98xa	2010	Nurses registered as members of the Hong Kong Nurses General Union, the Nurses Branch, and the Enrolled Nurses Branch of the Hong Kong Chinese Civil Servants Association were invited to participate in a self-administered anonymous questionnaire survey on infection control practices relating to influenza prevention that has been conducted every 1-2 years since 2006. The factors associated with a declining H1N1 vaccination rate might well be similar to those for seasonal influenza vaccination, because many nurses considered the 2 diseases to be of similar severity. In our study, .60% of the nurses had received seasonal influenza vaccination in the previous year; however, the estimated vaccination rate for the coming flu season had dropped to 37.5%, though some 20% of the respondents were undecided at the time of the survey.
cord-300754-q356npb7	2017	Of 7,772 laboratory-confirmed cases of respiratory viral infection among hospitalized patients, 22.8% were categorized as having hospital-acquired infection. The overall incidence of hospital-acquired respiratory viral infection was 3.9 (95% confidence interval, 3.7-4.1) cases per 1,000 admitted patients. The overall incidence of hospital-acquired respiratory virus infections was 3.9 cases per 1,000 admissions (95% confidence interval, 3.7-4.1) and 4.9 cases per 10,000 patient days (95% confidence interval, 4.7-5.2). Despite the inherent limitations of laboratory-based surveillance, which underestimated the disease burden, >20% of respiratory viral infections of hospitalized patients were categorized as hospital-acquired events, and various respiratory viruses were responsible. Of note, the influenza virus was responsible for only 13.9% of all hospital-acquired respiratory viral infections. 10 It has also been reported that respiratory viruses were responsible for 22.5% of cases of severe hospital-acquired pneumonia requiring ICU admission in adults.
cord-301988-cevv81h3	2015	BACKGROUND: The purpose of this study was to determine the seasonal variance of potentially pathogenic bacterial and viral organisms in nasopharyngeal specimens obtained from asymptomatic health care professionals (HCPs) during the 2014 winter and summer months. Although asymptomatic HCPs certainly harbor a number of different potentially infectious agents, future studies are needed to determine whether colonized pathogens are transmitted or initiate infection in at-risk patient populations. Here, we describe the frequency and seasonal variation of bacterial and viral detections in asymptomatic health care professionals (HCPs) during the winter and summer months of 2014. 4 By elucidating changes in pathogen colonization rates in asymptomatic HCPs during different time periods in the year, health care organizations can monitor which potentially pathogenic agents are most prevalent in carriers in a health care setting and observe correlations with infection levels in at-risk hospitalized patients.
cord-302103-mwlgvuag	2004	title: Assessing hospital preparedness using an instrument based on the Mass Casualty Disaster Plan Checklist: Results of a statewide survey METHODS: All short-term and long-term hospitals in Kentucky were surveyed using an instrument based on the Mass Casualty Disaster Plan Checklist and a brief supplemental bioterrorism preparedness questionnaire based on a checklist developed for the Agency for Healthcare Research and Quality. After considering several checklist type instruments, the task force selected the Mass Casualty Disaster Plan Checklist: A Template for Healthcare Facilities, developed by the Association of Professionals in Infection Control and Epidemiology (APIC) and the Center for the Study of Bioterrorism and Emerging Infections, 4 as the basis for the survey instrument. Most encouragingly, hospitals in MMRS counties reported more advanced pharmaceutical planning and preparedness, an area of critical importance in a bioterrorism event.
cord-302761-yila2wht	2020	Level I, II, & III gowns were tested for water resistance and hydrostatic pressure, along with other durability assessments (breaking, tear, and seam strength, pilling resistance, dimensional stability, air permeability, colorfastness, and fabric hand) per standard test methods. The number of samples and specimens taken from each gown type was dependent on the specific standard test method being conducted (i.e. three specimens for impact penetration, hydrostatic pressure, fabric weight, colorfastness, dimensional stability, four specimens for pilling resistance, five specimens for seam strength, and ten specimens for air permeability, breaking strength, tear strength, and thickness). Fabric weight and thickness were measured at new for the disposable gowns and after 1, 25, 50, and 75 industrial launderings (ILs) for the reusable gowns according to the ASTM standards listed in Table 2 . While all reusable gowns met minimum AAMI PB70 requirements for impact penetration and hydrostatic pressure water resistance, the disposable gowns in this study did not.
cord-303685-sxsrz60h	2005	Therefore, alcohol-based products must have a preservative agent such as iodine/iodophor compounds, chlorhexidine gluconate, or zinc pyrithione, to extend its antimicrobial effects. This work includes a literature review of current zinc pyrithione applications in drugs and cosmetics, a safety and toxicity evaluation, consideration of the proposed mechanisms of antimicrobial action, in vitro and in vivo efficacy data, and a discussion of the mechanisms that confer the desired antimicrobial persistence. The authors'' conclusion is that zinc pyrithione is not only a safe and effective antimicrobial but that its use in certain alcohol-based formulations results in antimicrobial efficacy exceeding that of iodine and chlorhexidine gluconate. Preservative systems in some of the currently marketed alcohol-based products for skin antisepsis include iodine/iodophors compounds, CHG, and zinc pyrithione (ZPT). Therefore, this article includes a brief review of the published literature related to the development, safety, efficacy, and clinical utility of ZPT and evaluating its merits as a preservative for alcohol-based products of skin antisepsis.
cord-304124-ym9mf5wz	2020	title: Meta-analysis investigating the relationship between clinical features, outcomes, and severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia METHODS: We performed a systematic review and meta-analysis using PubMed, Embase, and Cochrane Library databases to assess the clinical characteristics and outcomes of confirmed COVID-19 cases and compared severe (ICU) and non-severe (non-ICU) groups. The inclusion criteria were: (1) cohort studies or case-control studies reporting the clinical characteristics of patients with SARS-CoV2infection; (2) one or more clinical features were analyzed, including epidemiology, clinical symptoms, laboratory findings, comorbidities, treatment, complications, and outcomes; (3) patients were grouped according to the severity of disease, e.g., severe and non-severe groups or ICU and non-ICU groups. We extracted and analyzed items from eligible studies including the country, year, date of publication, the number of reported cases, sex, age, clinical symptoms and signs, comorbidities, laboratory findings, complications, and outcomes of patients with SARS-CoV2 infection who had severe (ICU) and non-severe (non-ICU) disease.
cord-305048-y42o6exe	2020	key: cord-305048-y42o6exe title: Chest tube with air leaks is a potential "super spreader" of COVID-19 cord_uid: y42o6exe [2] There is a concern that aerosols may also be generated from the chest tube, especially with air leaks, even after placement. We performed chest tube drainage and diagnosed an acute empyema with a bronchopleural fistula causing persistent air leaks. We strictly used personal protective equipment; nevertheless, another 7 people (2 physicians and 5 nurses) associated with the patient were infected with COVID-19. The outbreak of COVID-19 in our hospital was thought to be related to aerosols produced by the chest tube with air leaks. Further research is required to determine whether chest tubes with air leaks are a source of infectious aerosols. However, we clinicians should be attentive to the risk of nosocomial infection with COVID-19 due to chest tubes. COVID-19: chest drains with air leak -the silent ''super spreader
cord-306646-6c7n0xir	2020	This manuscript describes the experience of a Southern Italy Respiratory Unit for safely resuming outpatient respiratory services and preventing COVID-19 transmission. The Sars-CoV-2 infection is mainly transmitted by respiratory droplets 3 and close contact, and both respiratory clinicians and patients are at increased risk for transmission during the outpatient visit and the pulmonary function testing procedures. Therefore, a plan to manage the health issues of people with pre-existing chronic lung conditions is essential to prevent an inevitably indirect effect of COVID-19 on these frail patients that could be devastating, increasing deaths and disabilities. We need to change the way we provided care to patients so far and co-habit with the "silent enemy", since chronic severe medical conditions still exist despite COVID-19, and we need to take care of them taking urgent and effective actions in continuing to assist chronic respiratory diseases while preventing infection dissemination.
cord-306930-tuositq1	2015	BACKGROUND: There is limited literature on the frequency of face-touching behavior as a potential vector for the self-inoculation and transmission of Staphylococcus aureus and other common respiratory infections. CONCLUSION: Increasing medical students'' awareness of their habituated face-touching behavior and improving their understanding of self-inoculation as a route of transmission may help to improve hand hygiene compliance. 6 Staphylococcus aureus is carried in the nasal mucosa in approximately 25% of the community 7, 8 and, may be self-inoculated, via face touching, by individuals who are frequently exposed to potential carriers in both the community and health care settings. Meanwhile, raising awareness that face-touching behavior is common and is a possible vector in self-inoculation could result in HCWs accepting the message that hand hygiene before and after patient contact is an effective method of reducing colonization and infection transmission for themselves and their patients.
cord-307263-znuqdzdp	2020	Previous studies have shown that during sudden natural disasters and infectious diseases, nurses will sacrifice their own needs to actively participate in the anti-epidemic work and make selfless contributions out of moral and professional responsibility [7] . Previous studies have shown that when nurses are in close contact with patients with emerging infectious diseases such as SARS [9] , MERS-Cov [10, 11] , Ebola [12] , H1N1 [13] , they will suffer from loneliness, anxiety, fear, fatigue, sleep disorders, and other physical and mental health problems. This study explored the psychological experience of caregivers of patients with COVID-19 using phenomenological methods and we summarised our findings into four themes: significant amounts of negative emotions at an early stage, self-coping styles, growth under stress, and positive emotions that occur simultaneously or progressively with negative emotions.
cord-308546-wlnbpgz7	2020	Frequent systematic cleaning and disinfecting practices (CDP) are key in controlling the spread of infection 6 within in-patient settings, since pathogens can persist on surfaces for several weeks if left uncleaned [7] [8] [9] . Technological advancements have resulted in new cleaning and disinfecting tools and processes to improve the effectiveness of CDP to support infection control 10, 11 but cleaning standards and best practices are useful only if they are actually followed. Staff also provided feedback on the auditing process, suggesting approaches for improving the electronic auditing tool to reflect auditor information, discharge versus standard cleaning and other factors outside of the scope of this study. These findings highlight the need for improved cleaning standards, particularly as both hospitals and long term care facilities continue to treat COVID-19 patients and need to reduce the risk of hospital acquired cases. It also suggests that UV markers can play a key role in a systematic auditing program to measure effective cleaning of patient rooms.
cord-313409-3n4vyszl	2020	In a study of 1152 healthcare workers surveyed prior to the COVID-19 pandemic, most disagreed that respiratory protective equipment use interferes with patient care but reported that it would affect respirator use compliance if it did. In a study of 1152 healthcare workers surveyed prior to the COVID-19 pandemic, most disagreed that respiratory protective equipment use interferes with patient care but reported that it would affect respirator use compliance if it did. HCWs enrolled in a medical system''s respiratory protection program (RPP) were queried both during a focus group interview of eleven hospital staff members and a larger medical system-wide electronic survey of 1152 HCWs regarding their perceptions and beliefs about the impact of respirators on their ability to provide patient care (8) (9) . During a focus group interview in 2015, HCWs were asked to describe how use of respirators impacted their ability to provide care and whether patients or their family members interact differently with them when they are wearing respirators.
cord-314206-caxz025z	2010	Compared with controls, the EAPR resulted in significant decreases in breathing rate at both work rates and significantly increased tidal volume at the 1.7-mph work rate; otherwise, there were no statistically significant differences in measured physiological variables (Tables 1 and 2) There were no significant differences in mean mixed inhalation/exhalation respirator dead space carbon dioxide concentrations at 1.7 mph and 2.5 mph (P 5 .61) or respirator dead space oxygen concentrations at 1.7 mph or 2.5 mph (P 5 .80) ( Table 2 ). The study data indicate that the use of an EAPR by healthy HCWs, over 1 hour at work rates associated with the health care environment, was associated with statistically significant decreases in the breathing rate at 1.7 mph (P 5 .02) and 2.5 mph (P 5 .03) that was compensated by a significant increase in the tidal volume at 1.7 mph (P 5 .009) and nonsignificant increase at 2.5 mph (P 5 .14) compared with controls (Table 3) .
cord-316442-xwopn97m	2020	title: Global risk to the community and clinical setting: Flocking of fake masks and protective gears during the COVID-19 pandemic In accordance with ASTM F2299-03 international standard [6], our Squina International Centre for Infection Control established a system to estimate the Particle Filtration Efficiency (PFE) of face mask. However, general public and even healthcare professionals may be unable to distinguish the counterfeit and fake face masks from those quality one. Our test results were alarming because using fake masks / protective gears will jeopardize the health of COVID-19 patients, suspected cases, close contacts, and vulnerable subpopulation (health professionals, older adults, patients with chronic disease, poverty). Illegal fake mask and protective gears manufacturing may disrupt the infection prevention and control towards the COVID-19 outbreak in clinical and community settings. The local government should educate the general public to distinguish between good quality masks with those fake face masks via social media.
cord-317138-6nonzjbq	2020	title: The higher temperature and ultraviolet, the lower COVID-19 prevalence – Meta-regression of data from large U.S. cities We obtained 1) integrated number of confirmed COVID-19 cases in the county (to which the city belongs) on 14 May 2020 from Johns Hopkins Coronavirus Resource Center (https://coronavirus.jhu.edu), 2) estimated population in 2019 in the county from U.S. Census Bureau, and 3) monthly meteorological conditions at the city for 4 months (from January to April 2020) from National Weather Service (https://www.weather.gov), World Weather Online (https://www.worldweatheronline.com), and Global Solar Atlas (https://globalsolaratlas.info/map) ( Table 1) . Results of the meta-regression were summarized in Table 2 The present meta-regression suggests that temperature, UV index, sun hours, and solar DNI may be negatively, and wind speed and sky cover may be positively associated with COVID-19 prevalence.
cord-319833-u9uuuu38	2020	METHODS: We performed a systematic review of the literature in order to identify studies reporting outcomes of at least one decontamination method for inactivating or removing any potentially infectious material from the surface of N95 FFRs, specifically addressing issues related to reduction of the microbial threat (including SARS-CoV-2 when available), maintaining the function of N95 FFRs and a lack of residual toxicity. 10 Although various decontamination methods have been used, there are concerns over certain characteristics of the N95 FFRs with respect to their utilization, such as alterations in their physical appearance/odor, structural integrity, filtration efficiency, fit and seal and filter airflow resistance, degradation of their material, and chemical residues that are potentially toxic or irritate the skin (due to the chemical disinfectants required for rinsing and drying).
cord-322923-zxraxgl1	2020	Providence created simple masks using surgical wrap and submitted samples to an environmental lab for bacterial filtration efficiency testing. Providence created simple masks using surgical wrap and submitted samples to an environmental lab for bacterial filtration efficiency testing. Healthcare quality masks are rated based on bacterial and particulate filtration efficiency as well as fluid resistance, differential pressure, and flammability. BFE results ranged from 83.0% to 97.7% in one ply masks produced with Medline GEM 1, 2, and 3 (materials are distributed as single ply and were separated prior to mask manufacture). The rapid creation and manufacture of simple surgical masks with similar bacterial filtration efficiency as ASTM 1 rated masks illustrates one method for future planning in the event that mask shortages arise again. Although not ideal, the use of surgical wrap to quickly produce a high quality isolation mask does offer a feasible solution when mask supplies are critically low to ensure healthcare services can continue to be provided while keeping healthcare workers safe.
cord-325598-gy809ee0	2020	title: Asymptomatic carriers of COVID-19 in a confined adult community population in Quebec: a cross-sectional study In our cross-sectional study, 1.82% of 330 asymptomatic confined individuals living in the community carried SARS-CoV-2 despite no contact with declared cases, raising concerns about unnoticed transmission. Cloutier, Lyne 1 ; Merindol, Natacha 2,3 ; Pépin, Geneviève 4 ; Marcoux-Huard, Caroline 5 ; Vasil, Pier-Alexandre 5 ; Houle, Claudia 6, 7 ; Todkar, Shweta 1 ; Lehoux, Marie-Claude 3 ; Houle, Nathalie 1 ; Germain, Hugo 2,3 ; Danylo, Alexis 6  SARS-CoV-2 may spread asymptomatically in a population under social distancing restrictions. Studies conducted on individuals from the same households have convincingly shown that pre-symptomatic or asymptomatic SARS-CoV-2 carriers might transmit to their family members [8] [9] [10] . Transmission potential of asymptomatic and paucisymptomatic SARS-CoV-2 infections: a three-family cluster study in China.
cord-326887-lyewg2c9	2007	The effectiveness of hand hygiene procedures in reducing the risks of infections in home and community settings including handwashing and alcohol-based hand sanitizers There can be no doubt that advances in hygiene during the 19th and 20th centuries, along with other aspects of modern medicine, have combined to improve both the length and quality of our lives. The data suggest the following: d For reservoir sites such as the sink waste pipes or toilets, although the probability of contamination (potentially pathogenic bacteria or viruses) is high, the risk of transfer is limited unless there is a particular risk situation (eg, a family member with enteric infection and fluid diarrhea, when toilet flushing can produce splashing or aerosol formation that can settle on contact surfaces around the toilet). Although handwashing intervention studies provide data supporting the causal link between hand contamination and ID transmission, defining the importance of hand hygiene relative to other hygiene practices, such as surface and cleaning cloth hygiene, or the risks associated with airborne transmission is difficult because of the close interdependence of these factors.
cord-328116-jnll9g6g	2020	-Novel UV-C device found to significantly decrease total and pathogenic bacteria on mobile phones -UV-C phone disinfecting device is renewable, efficient and effective -UV-C device implementation in a hospital system would be desired by healthcare providers -Healthcare providers felt their mobile phones were an important risk factor in infection transmission and that they would use this device daily to weekly -UV-C technology is shown to kill coronaviruses and implementation of this device could be impactful during pandemic Abstract: We utilize an Ultraviolet-C (UV-C) device to provide an effective method for mobile phone disinfection and survey HCPs about infection risk. We utilize an Ultraviolet-C (UV-C) device to provide an effective method for mobile phone disinfection and survey HCPs about infection risk. Ultraviolet light presents a renewable, effective, and easy-to-use disinfection method that has the potential to conserve hospital resources and decrease the healthcare-associated transmission of bacteria and viruses.
cord-330463-j4cf7vzs	2016	In this international workshop, a panel of 6 experts will expound on the following: (1) the potential for indoor air to spread a wide range of human pathogens, plus engineering controls to reduce the risk for exposure to airborne infectious agents; (2) the behavior of aerosolized infectious agents indoors and the use of emerging air decontamination technologies; (3) a survey of quantitative methods to recover infectious agents and their surrogates from indoor air with regard to survival and inactivation of airborne pathogens; (4) mathematical models to predict the movement of pathogens indoors and the use of such information to optimize the benefits of air decontamination technologies; and (5) synergy between different infectious agents, such as legionellae and fungi, in the built environment predisposing to possible transmission-related health impacts of aerosolized biofilm-based opportunistic pathogens.
cord-330666-puhijixa	2007	BACKGROUND: This pilot study was conducted to determine whether supplementing standard classroom training methods regarding respiratory disease transmission with a visual demonstration could improve the use of personal protective equipment among emergency department nurses. CONCLUSION: Supplementing the standard training methods with a visual demonstration can improve the use of personal protective equipment during care of patients exhibiting respiratory symptoms. We used pre-/posttest knowledge assessments and observations of HCW-patient interactions to evaluate the impact of the visual demonstration of respiratory disease transmission on PPE use by HCWs. The study was conducted during the peak of the 2005 influenza season (January to March) to ensure that the HCWs could be observed interacting with the greatest number of patients with respiratory symptoms. Observers with experience in the education and training of health care personnel were trained to recognize and evaluate the use of PPE by study participants during real patient interaction.
cord-331848-tysxrc4o	2020	Assessing the use of blue surgical sterilization wrap for homemade respirator masks during the COVID-19 crisis. The use of surgical sterilization wrap for respirator masks during the COVID-19 crisis has become a popularized personal protective equipment alternative option due to claims supporting its ability to meet N95 standards. The tested material failed to meet N95 standards and suggests its use may place medical personnel at increased risk of harm when managing COVID-19 patients. We sought to subject the popularly used surgical sterilization wrap material used for respirator mask creation to these strict quantitative NIOSH N95 standards via standardized industrial testing. The sterilization wrap was subjected to TSI 8130 automated filter testing in accordance with NIOSH standards for the N95 respirator mask. 6 To our knowledge these results are the first to assess the safety and efficacy of the Halyard H600 instrument wrap as a respiratory mask alternative for the COVID-19 pandemic.
cord-332243-6uc4ricy	2010	This article reports a study investigating hand and environmental contamination levels when health care workers (HCWs) followed two different methods of removing gloves at two distances from the rubbish bin. The study set out to examine the hand contamination rates and environmental contamination levels when (1) different methods of glove removal were followed, including personal or causal methods (pretest) and the CDC''s recommended method (posttest), and (2) the distance to the bin varied between 2 feet and 3 feet (customary distances used by HCWs in Hong Kong), measured in the common gown down areas (ie, designated areas for HCWs to gown down their PPE) in the fever and cohort wards (wards for patients with epidemiological and clinical information suggestive of a similar diagnosis to share rooms, and with a spatial separation of at least 1 meter from one another) of a public hospital in Hong Kong.
cord-332815-1w1ikj7q	2020	METHODS: Based on their prior experience with the 2003 SARS epidemic, health authorities in China recognized the need for personal protective equipment (PPE). Existing PPE and protocols were limited and reflected early experience with SARS; however, as additional PPE supplies became available, designated COVID-19 hospitals in Hubei Province adopted the World Health Organization guidelines for Ebola to create a protocol specific for treating patients with COVID-19. The paper focuses primarily on the use of PPE to help prevent transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to HCWs. The aim is to provide more detail regarding level-3 protection protocols used at designated COVID-19 hospitals in Hubei Province to prevent the spread of the virus to HCWs. The methods to protect HCWs, designated as level-3 protection in China, included a personal protection protocol for proper use of PPE with coveralls and procedures for changes to the flow of patients and personnel through the designated COVID-19 hospitals.
cord-333950-e0hd3iuu	2020	The authors call upon national and international policy makers, health agencies and healthcare professionals to further recognize the importance of targeted hygiene in the home and everyday life settings for preventing and controlling infection, in a unified quest to tackle AMR. 3, 4 The main driver is overuse and misuse of antibiotics in medicine and agriculture including unregulated over-the-counter sales, while global spread of resistant bacteria or resistance genes is attributed to poor infection prevention and control in healthcare facilities, and sub-optimal hygiene and sanitation in communities, confounded by poor infrastructure and weak governance. 94 Studies in day-care centers and schools in which hand hygiene was combined with cleaning and/or disinfection of environmental surfaces indicate a positive impact on illness rates and reduction in the use of antibiotics. The evidence set out in this paper suggests that, if combined with measures ensuring clean water and adequate sanitation, targeted hygiene practices in home and everyday life settings could make a significant contribution to tackling AMR through infection prevention and a consequential reduction in antibiotic prescribing.
cord-339245-02gr4mfy	2020	• Digital survey applications can be used to create highly infectious disease screening tools; • Digital screening tools simplify patient screening for non-clinical staff at facility entrances; • Digital screening tools can be monitored remotely to assist with compliance.  Digital survey applications can be used to create highly infectious disease screening tools  Digital screening tools simplify patient screening for non-clinical staff at facility entrances  Digital screening tools can be monitored remotely to assist with compliance Quick identification and isolation of patients with highly infectious diseases is extremely important in healthcare settings today. The large number of survey submissions received during the intervention time period indicated that healthcare personnel were successfully able to use the digital measles tool to quickly screen patients at healthcare facility entrances. The results of the intervention indicate that digital survey applications are effective alternatives to other infectious disease screening methods due to their ease of use by non-clinical staff working near healthcare facility entrances, and their remote compliance monitoring capabilities.
cord-339362-crtlkju1	2020	Despite benefits such as improved patient care coordination and access to patient information, 1 the electronic medical record (EMR) in its current state poses significant barriers to infection preventionists'' (IP) work efficiency during a pandemic. Electronic medical record barriers highlighted during the COVID-19 pandemic include rapid notification of suspected or confirmed COVID-19 patients, tracking suspect or confirmed cases who have been tested at an outside facility or during a previous hospital visit, and triggering the automatic implementation of isolation orders (Table 1) . Because most EMRs do not communicate between health systems, delayed IP notification of suspected or confirmed COVID-19 patients at the time of facility-to-facility transfer may hinder prompt application of appropriate isolation precautions and lead to staff exposure. Notification of patient isolation needs to frontline staff in real time via the EMR is yet another barrier highlighted during the COVID-19 pandemic.
cord-340051-r9kn34wd	2020	(4) The number of days since the onset of the disease needed for the symptoms to disappear was associated with the epidemiological history (imported cases), the number of days until the pharyngeal swab nucleic acid test turned negative, the days of hospitalization, the days of onset, and the WBC and LYM count levels (P < 0.05). The discharged patient had to conform to the following conditions 6 : (1) The patient'' temperature returned to normal for more than three days; (2) respiratory symptoms improved significantly; lung imaging showed a significant improvement in acute exudative lesions; (3) the RT-PCR test of pharyngeal swab samples had two consecutive negative results (at least 24 hours apart), and we recorded the earliest date the nucleic acid test turned negative. The days until the symptoms disappeared in patients with COVID-19 were positively correlated with the history of epidemiology (imported cases),the days needed for the pharyngeal swab nucleic acid test to turn negative, and the days of hospitalization.
cord-342523-52t7dh4n	2020	The current report describes a need for selective stool testing to explore fecal shedding of viral RNA and presents a hypothesis for direct infection of enterocytes in cases of hypochlorhydria. Clinical and virological aspects of enteric COVID-19 disease have been reviewed, with authors suggesting the need for study of possible fecal-oral transmission (1, 3) . The purposes of this brief report are to emphasize the importance of testing stool samples under certain conditions and to suggest a novel route of direct enterocyte infection by COVID-19 in cases of developmental or acquired hypochlorhydria. Although there is observational evidence that long-term or high-level use of PPI is associated with an increased risk of testing positive for COVID-19 (10), certain histamine-2 receptor antagonists (H2RA) and a PPI have been observed to improve disease outcome in patients already infected with COVID-19 virus (11) .
cord-345210-6f8niif5	2020	The rapid creation and unusual configuration of this facility, together with the challenges of new clinical teams unfamiliar with one another, and working together in uncomfortable PPE to provide high-quality patient care, necessitated some basic approaches to the development of our IPC program. The plan identified the need for engineering controls (e.g. specifications for heating, ventilation, and air conditioning systems) and specified occupational IPC health and safety requirements, including PPE standards, daily monitoring of staff for acute illness, sanitation standards for both hand hygiene and equipment sanitation, as well as laundry and waste management recommendations. Key lessons learned included the need to: develop strategies to cope with real and potential shortages of critical supplies; adapt existing guidance for unique sites of care; standardize and continually assess staff use of PPE and fundamental IPC practices; and the importance of communication of IPC principles and concerns throughout the planning and management of this COVID ACS.
cord-351031-e8suoeim	2020	In these general wards, termed as respiratory surveillance wards (RSWs), an infection control bundle was implemented comprising infrastructural enhancements, improved personal-protective-equipment (PPE), and social distancing between patients, in order to mitigate the risk of a potential COVID-19 case initially admitted outside of an AIIR. The main finding of our study was that an infection control bundle comprising infrastructural enhancements, improved PPE and social distancing mitigated the risk of environmental contamination and transmission in a cohorted general ward setting. In conclusion, over a 3-month period, our institution implemented a bundle of interventions to reduce risk of intra-hospital transmission of COVID-19 in a multi-bedded cohorted general ward setting, through the implementation of an infection control bundle comprising infrastructural enhancements, improved PPE, and social distancing between patients.