# ent

id: cord-261595-c69vfs8q
type: ORG
entity:
  Hygiene Task Force Society for Healthcare Epidemiology of America Association for Professionals in Infection Control Infectious Diseases Society of America


id: cord-273531-q9ah287w
type: ORG
entity:
  National Health Commission Ministry of Human Resources and Social Security Ministry of Finance Measures


id: cord-257595-l8bsoqbx
type: GGP
entity:
  TGF β Induced Epithelial to Mesenchymal Transition Corruption Perceptions Index Pearson r computation with Correlation Vitamin D


id: cord-257595-l8bsoqbx
type: DISEASE
entity:
  stomach colorectal liver and gallbladder pancreas lung female breast prostate bladder and kidney cancers


id: cord-253240-rtv136j7
type: CELL_LINE
entity:
  4 monolayer cell culture tubes rhesus monkey kidney Hep 2 and 2 MRC 5 human fetal lung fibroblast cell line Binax


id: cord-253240-rtv136j7
type: ORG
entity:
  Prospective Multicenter Study of Viral Etiology and Hospital Length of Stay in Children With Severe Bronchiolitis Rapid


id: cord-253240-rtv136j7
type: DISEASE
entity:
  influenza A influenza B parainfluenza viruses 1 2 and 3 adenovirus or respiratory syncytial virus RSV D 3 Ultra Respiratory Screening


id: cord-009114-mdlthnnp
type: ORG
entity:
  the Centers for Disease Control and Prevention Healthcare Infection Control Practices Advisory Committee


id: cord-034660-g28qmyh8
type: ORG
entity:
  the National Academies of Sciences Engineering and Medicine entitled Encouraging Adoption of Protective Behaviors


id: cord-276758-k2imddzr
type: DNA
entity:
  ucNavMenu_TSMenuTargetType54 ucNavMenu_TSMenuID56 id51613 Streptococcus salivarius meningitis following myelography Streptococcal meningitis complicating diagnostic myelography three cases and review Streptococcal meningitis after myelography Iatrogenic meningitis an increasing role for resistant viridans streptococci Case


id: cord-276758-k2imddzr
type: GGP
entity:
  I B 3 c Airborne Transmission Airborne transmission occurs by dissemination of either airborne droplet


id: cord-276758-k2imddzr
type: ORG
entity:
  the Guidelines for Prevention of Transmission of Tuberculosis in Hospitals and Other Health Care Settings


id: cord-276758-k2imddzr
type: ORG
entity:
  The Centers for Disease Control and Prevention s National Institute for Occupational Safety and Health


id: cord-276758-k2imddzr
type: ORG
entity:
  Hygiene Task Force Society for Healthcare Epidemiology of America Association for Professionals in Infection Control Infectious Diseases Society of America Guideline


id: cord-276758-k2imddzr
type: ORG
entity:
  Society for Healthcare Epidemiology of America and Infectious Diseases Society of America Joint Committee on the Prevention of Antimicrobial Resistance


id: cord-276758-k2imddzr
type: DISEASE
entity:
  myocardial infarction congestive heart failure overdose stroke gastrointestinal bleeding renal failure hepatic failure multiorgan system failure


id: cord-279640-n391v32y
type: ORG
entity:
  the National Nosocomial Infections Surveillance NNIS System the National Surveillance System for Healthcare Workers NaSH


id: cord-279640-n391v32y
type: ORG
entity:
  the Dialysis Surveillance Network DSN ONCHIT Office of the National Coordinator for Health Information Technology


id: cord-333950-e0hd3iuu
type: WORK_OF_ART
entity:
  A Microbiological Survey of Campylobacter Contamination in Fresh While UK Produced Chilled Chickens at Retail Sale Centers for Disease Control and Prevention Campylobacteriosis


id: cord-333950-e0hd3iuu
type: ORG
entity:
  Home Hygiene Minimum Infective Dose of the Major Human Respiratory and Enteric Viruses Transmitted Through Food and


id: cord-333950-e0hd3iuu
type: ORG
entity:
  Multiple Cleaning and Disinfection Interventions on Infectious Diseases in Children A Group Randomized Trial


id: cord-333950-e0hd3iuu
type: ORG
entity:
  Preservation Wolters Kluwer Philadelphia Scientific Committee on Emerging and Newly Identified Health Risks SCENIHR Recent


id: cord-295469-5an7836u
type: DISEASE
entity:
  Stachybotrys chartarum enteric viruses noro and rotaviruses respiratory viruses influenza and coronaviruses mycobacteria tuberculous


id: cord-291742-donflx7w
type: ORG
entity:
  the Johns Hopkins Armstrong Institute Comprehensive Unit Based Safety Program for Mechanically Ventilated Patients and Ventilator Associated


id: cord-291742-donflx7w
type: DISEASE
entity:
  influenza virus respiratory syncytial virus adenovirus parainfluenza virus rhinovirus human metapneumovirus or coronavirus Ventilator


id: cord-302761-yila2wht
type: WORK_OF_ART
entity:
  Sewn Seams of Woven Apparel Fabrics American Society for Testing and Materials ASTM D737 Standard Test Method for Air Permeability of Textile Fabrics American Association of Textile Chemists and


id: cord-290441-r4tzodkj
type: ORG
entity:
  Reduction of Healthcare Associated Infections by Exceeding High Compliance with Hand Hygiene Practices Systematic


id: cord-328116-jnll9g6g
type: WORK_OF_ART
entity:
  Shining a Light on the Pathogenicity of Health Care Providers Mobile Phones Use of a Novel Ultraviolet C Wave Disinfection Device


id: cord-326887-lyewg2c9
type: ORG
entity:
  Global Influenza Preparedness Plan World Health Organization WHO Global Influenza Preparedness Plan World Health Organization Writing Group Nonpharmaceutical


id: cord-319833-u9uuuu38
type: ORG
entity:
  Infectious Diseases Society of America Guidelines on Infection Prevention for Health Care Personnel Caring for Patients


id: cord-319833-u9uuuu38
type: ORG
entity:
  N95 Respirator Filtration Performance and Structural Integrity Evaluation of Multiple 3 Cycle Decontamination Processing for Filtering Facepiece Respirators Ultraviolet


id: cord-304124-ym9mf5wz
type: PROTEIN
entity:
  protein procalcitonin lactose dehydrogenase aspartate aminotransferase alanine aminotransferase creatinine kinase


id: cord-304124-ym9mf5wz
type: DISEASE
entity:
  chronic obstructive pulmonary disease COPD diabetes hypertension coronary heart disease cerebrovascular diseases


id: cord-302103-mwlgvuag
type: CELL_LINE
entity:
  Mass Casualty Disaster Plan Checklist A Template for Healthcare Facilities developed by the Association of Professionals in Infection Control and Epidemiology APIC


id: cord-302103-mwlgvuag
type: ORG
entity:
  the Centers for Disease Control and Prevention CDC Hospital Infections Program Bioterrorism Working Group 9


id: cord-325598-gy809ee0
type: FAC
entity:
  Marcoux Huard Pier Alexandre Vasil Claudia Houle Shweta Todkar Marie Claude Lehoux Nathalie Houle Hugo Germain Alexis Danylo


id: cord-351031-e8suoeim
type: ORG
entity:
  Wuhan China Centres for Disease Control and Prevention USA Interim Infection Prevention and Control Recommendations for Patients with Suspected


id: cord-351031-e8suoeim
type: WORK_OF_ART
entity:
  a Long Term Care Facility King County Clinical and Transmission Characteristics of Covid 19 A Retrospective Study of 25 Cases


id: cord-340051-r9kn34wd
type: DISEASE
entity:
  cough runny nose sore pharyngeal sore pharyngeal chest tightness chest pain shortness of breath and dyspnea Gastrointestinal symptoms


# bib

id: cord-007828-c7jxj74b
title: Middle East respiratory syndrome coronavirus infection control: The missing piece?
author: Memish, Ziad A.
date: 2014-11-25
txt: ./txt/cord-007828-c7jxj74b.txt
cache: ./cache/cord-007828-c7jxj74b.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7124258/
doi: 10.1016/j.ajic.2014.08.003
abstract: nan
summary:
  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


id: cord-009114-mdlthnnp
title: Isolation anterooms: Important components of airborne infection control
author: Subhash, Shobha S.
date: 2012-10-02
txt: ./txt/cord-009114-mdlthnnp.txt
cache: ./cache/cord-009114-mdlthnnp.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7135637/
doi: 10.1016/j.ajic.2012.06.004
abstract: nan
summary:
  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.


id: cord-009169-hzxgi1t0
title: Nosocomial infection in China: Management status and solutions
author: Sun, Bingwei
date: 2016-07-01
txt: ./txt/cord-009169-hzxgi1t0.txt
cache: ./cache/cord-009169-hzxgi1t0.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7135812/
doi: 10.1016/j.ajic.2016.01.039
abstract: nan
summary:
  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.


id: cord-034660-g28qmyh8
title: Using Persuasion Science to Improve COVID-19 Contact Tracing
author: Sciamanna, Christopher
date: 2020-11-05
txt: ./txt/cord-034660-g28qmyh8.txt
cache: ./cache/cord-034660-g28qmyh8.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7642730/
doi: 10.1016/j.ajic.2020.11.004
abstract: nan
summary:
  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 ).


id: cord-253240-rtv136j7
author: McGrath, Eric J.
date: 2013-03-16
txt: ./txt/cord-253240-rtv136j7.txt
cache: ./cache/cord-253240-rtv136j7.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.ajic.2013.01.010
doi: 10.1016/j.ajic.2013.01.010
summary:
  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.

title:
  Detection of respiratory coinfections in pediatric patients using a small volume polymerase chain reaction array respiratory panel: More evidence for combined droplet and contact isolation

abstract:
  BACKGROUND: In fall 2009, Children’s Hospital of Michigan (CHM) instituted combined isolation precautions (contact and droplet isolation) for pediatric inpatients with upper respiratory infection (URI) symptoms to prevent health care-associated infection. METHODS: Pediatric patients with symptoms of URI had nasopharyngeal (NP) swab samples obtained prospectively between January and April and September and December 2010 for small volume polymerase chain reaction (SVPCR) array respiratory panel (RP) multiplex nucleic acid testing. NP swabs or nasal washes were obtained for viral culture and rapid antigen testing (RAT). RESULTS: Of 499 evaluable SVPCR array RP samples, 344 (69%) tested positive for at least 1 of the 21 tested organisms. The most commonly identified pathogen was rhinovirus/enterovirus (181/344 [53%]) for which no RAT exists at CHM. Of 344 positive specimens, 57 (17%) had at least 2 identified pathogens; 8 (2%) of these had 3. In 11% of patients, molecular testing detected pathogens or pathogen combinations requiring both contact and droplet precautions. CONCLUSION: SVPCR array RP testing detected respiratory pathogens in pediatric patients with URI at rates higher than that of RAT and viral culture. Because of the pathogens and pathogen combinations detected, the study findings suggest that combined contact and droplet isolation precautions may be warranted to prevent health care-associated infection in pediatric inpatients with URI. Further studies will be needed to confirm these results.


id: cord-253487-gl5lozn9
author: Jeanes, Annette
date: 2019-07-27
txt: ./txt/cord-253487-gl5lozn9.txt
cache: ./cache/cord-253487-gl5lozn9.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0196655319306455
doi: 10.1016/j.ajic.2019.06.014
summary:
  [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.

title:
  Moving beyond hand hygiene monitoring as a marker of infection prevention performance: Development of a tailored infection control continuous quality improvement tool

abstract:
  BACKGROUND: Infection control practice compliance is commonly monitored by measuring hand hygiene compliance. The limitations of this approach were recognized in 1 acute health care organization that led to the development of an Infection Control Continuous Quality Improvement tool. METHODS: The Pronovost cycle, Barriers and Mitigation tool, and Hexagon framework were used to review the existing monitoring system and develop a quality improvement data collection tool that considered the context of care delivery. RESULTS: Barriers and opportunities for improvement including ambiguity, consistency and feasibility of expectations, the environment, knowledge, and education were combined in a monitoring tool that was piloted and modified in response to feedback. Local adaptations enabled staff to prioritize and monitor issues important in their own workplace. The tool replaced the previous system and was positively evaluated by auditors. Challenges included ensuring staff had time to train in use of the tool, time to collect the audit, and the reporting of low scores that conflicted with a target-based performance system. CONCLUSIONS: Hand hygiene compliance monitoring alone misses other important aspects of infection control compliance. A continuous quality improvement tool was developed reflecting specific organizational needs that could be transferred or adapted to other organizations.


id: cord-257595-l8bsoqbx
title: COVID-19 Fatalities, Latitude, Sunlight, and Vitamin D
author: Whittemore, Paul B.
date: 2020-06-26
txt: ./txt/cord-257595-l8bsoqbx.txt
cache: ./cache/cord-257595-l8bsoqbx.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.ajic.2020.06.193
doi: 10.1016/j.ajic.2020.06.193
summary:
  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.

abstract:
  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. METHODS: Eighty-eight countries were selected based on their likelihood of providing reliable data. Using death rates/million for each country from the “worldometer” web site, a correlation analysis was done between death rates and a country's latitude. RESULTS: A highly significant, positive correlation was found between lower death rates and a country's proximity to the equator (Pearson r = .40 p<.0001, two-tailed t-test). The R squared of .16 means that 16% of the variation in death rates among nations is accounted for by the latitude of the country. Evidence is presented suggesting a direct correlation between sunlight exposure and reduced mortality. DISCUSSION: 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. Limitations of this study are noted. CONCLUSION: Further research is needed to confirm the correlation between latitude and COVID-19 fatalities, and to determine the optimum amounts of safe sunlight exposure and/or vitamin D oral supplementation to reduce COVID-19 fatalities in populations that are at high risk for vitamin D deficiency.


id: cord-259279-8dspud40
title: Barrier Resistance of Double Layer Isolation Gowns
author: Kahveci, Zafer
date: 2020-10-17
txt: ./txt/cord-259279-8dspud40.txt
cache: ./cache/cord-259279-8dspud40.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0196655320309287?v=s5
doi: 10.1016/j.ajic.2020.09.017
summary:
  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.

abstract:
  Isolation gowns are one of the crucial pieces of personal protective equipment (PPE) to prevent the migration of microorganisms and body fluids from patients to healthcare personnel and vice versa. Underperforming isolation gowns in terms of fluid resistance, could potentially put lives in danger. Wearing multiple layers of isolation gowns could theoretically increase the fluid penetration resistance. Extraordinary circumstances such as epidemics/pandemics and product recalls, bring extra burden on the health institutions in terms of PPE availability. Thus, shortages could occur, and PPE that provides an appropriate level of protection might not be available. Therefore, wearing multiple layers of lower barrier level gowns could be assumed as a solution. This study investigates if two-layer lower barrier level isolation gowns meet the barrier effectiveness requirements of a single higher barrier level isolation gown. Three ANSI/AAMI PB70 Level 2 isolation gowns were tested based on the ANSI/AAMI PB70 standard, in single and double-layer configuration. 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.


id: cord-259338-q3kw6n9o
author: Jean, Sim Xiang Ying
date: 2020-11-04
txt: ./txt/cord-259338-q3kw6n9o.txt
cache: ./cache/cord-259338-q3kw6n9o.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0196655320309718
doi: 10.1016/j.ajic.2020.11.003
summary:
  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.

title:
  Utilizing the Electronic Health Records to Create a Syndromic Staff Surveillance System During the COVID-19 outbreak

abstract:
  Objectives Since December 2019, COVID-19 has caused a worldwide pandemic and Singapore has seen escalating cases with community spread. Aggressive contact tracing and identification of suspects has helped to identify local community clusters, surveillance being the key to early intervention. Healthcare workers have contracted COVID-19 infection both at the workplace and community. 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. Methods/Results A prototypical surveillance system was built on existing electronic health record infrastructure. Over a 10-week period, we investigated 10 ARI clusters amongst 7 departments. One of the ARI clusters was later determined to be related to COVID-19 infection. We demonstrate the feasibility of syndromic surveillance to detect ARI clusters during the COVID-19 outbreak. 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. It could be an important tool in infection prevention within healthcare institutions.


id: cord-259461-ig9g1o8b
author: Choi, Jeong Sil
date: 2020-04-11
txt: ./txt/cord-259461-ig9g1o8b.txt
cache: ./cache/cord-259461-ig9g1o8b.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32289344/
doi: 10.1016/j.ajic.2020.04.002
summary:
  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.

title:
  Effects of nursing organizational culture and job stress on Korean infection control nurses’ turnover intention

abstract:
  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. Job stress was the most significant factor affecting ICNs’ turnover intention. To reduce ICNs’ turnover intention, their task stress needs to be lowered and managed. In particular, efforts should be made to establish a relation-oriented organizational culture that values positive relationships while enhancing their community spirit at the organization level.


id: cord-259639-j7pmb3mk
author: Cadnum, Jennifer L.
date: 2020-06-06
txt: ./txt/cord-259639-j7pmb3mk.txt
cache: ./cache/cord-259639-j7pmb3mk.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S019665532030359X
doi: 10.1016/j.ajic.2020.06.002
summary:
  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.

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

abstract:
  In the setting of the coronavirus disease 2019 pandemic, efficient methods are needed to decontaminate shared portable devices and large open areas such as waiting rooms. We found that wheelchairs, portable equipment, and waiting room chairs were frequently contaminated with potential pathogens. 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.


id: cord-261595-c69vfs8q
title: Religion and culture: Potential undercurrents influencing hand hygiene promotion in health care
author: Allegranzi, Benedetta
date: 2008-10-03
txt: ./txt/cord-261595-c69vfs8q.txt
cache: ./cache/cord-261595-c69vfs8q.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/18834738/
doi: 10.1016/j.ajic.2008.01.014
summary:
  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.

abstract:
  BACKGROUND: Health care–associated infections affect hundreds of millions of patients worldwide each year. The World Health Organization's (WHO) First Global Patient Safety Challenge, “Clean Care is Safer Care,” is tackling this major patient safety problem, with the promotion of hand hygiene in health care as the project's cornerstone. WHO Guidelines on Hand Hygiene in Healthcare have been prepared by a large group of international experts and are currently in a pilot-test phase to assess feasibility and acceptability in different health care settings worldwide. METHODS: An extensive literature search was conducted and experts and religious authorities were consulted to investigate religiocultural factors that may potentially influence hand hygiene promotion, offer possible solutions, and suggest areas for future research. RESULTS: Religious faith and culture can strongly influence hand hygiene behavior in health care workers and potentially affect compliance with best practices. Interesting data were retrieved on specific indications for hand cleansing according to the 7 main religions worldwide, interpretation of hand gestures, the concept of “visibly dirty” hands, and the use of alcohol-based hand rubs and prohibition of alcohol use by some religions. CONCLUSIONS: The impact of religious faith and cultural specificities must be taken into consideration when implementing a multimodal strategy to promote hand hygiene on a global scale.


id: cord-261736-jlwctmxw
title: Bacteria emitted in ambient air during bronchoscopy—a risk to health care workers?
author: Marchand, Geneviève
date: 2016-12-01
txt: ./txt/cord-261736-jlwctmxw.txt
cache: ./cache/cord-261736-jlwctmxw.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.ajic.2016.04.241
doi: 10.1016/j.ajic.2016.04.241
summary:
  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.

abstract:
  BACKGROUND: Health care workers are at risk of occupational infections, and some procedures are known to increase this risk. The aim of this study was to qualify and quantify bioaerosol concentrations during bronchoscopy to estimate the occupational risk. METHODS: Full-day sampling was conducted in 2 rooms while bronchoscopies were performed on patients. Two microbial air samplers were used, a wet wall cyclonic sampler and an impactor, on culture media. Identification of the culturable bacterial flora was performed with chromatographic analysis of cellular fatty acid of the isolated strain and additional biochemical tests if needed. Specific polymerase chain reaction analysis was completed on wet wall cyclonic samples for the detection of influenza A and B and Mycobacterium spp. RESULTS: A wide variety of bacteria were collected from the ambient air. All samples yielded at least 1 Staphylococcus species. Although most of the culturable bacteria identified were normal nonpathogenic flora, such as Streptococcus spp, Neisseria spp, and Corynebacterium spp, some opportunistic pathogens, such as Streptococcus pneumoniae, were found. Neither Mycobacterium spp nor influenza virus was detected with the polymerase chain reaction method during this study. CONCLUSIONS: Culturable bacteria from oral, nasal, and pulmonary flora are aerosolized during bronchoscopy and could be inhaled by medical staff. The potential presence of pathogens in those aerosols could represent an occupational infection risk.


id: cord-264972-hrbo3awj
author: Yee, Colin
date: 2016-11-01
txt: ./txt/cord-264972-hrbo3awj.txt
cache: ./cache/cord-264972-hrbo3awj.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.ajic.2016.04.221
doi: 10.1016/j.ajic.2016.04.221
summary:
  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.

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

abstract:
  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. Decisions regarding continuation of empirical antiviral therapy appear to be impacted by the test. However, the impact on reducing antibiotic use remains unclear.


id: cord-266667-6isk8jgj
author: Fix, Gemmae M.
date: 2019-06-07
txt: ./txt/cord-266667-6isk8jgj.txt
cache: ./cache/cord-266667-6isk8jgj.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.ajic.2019.04.174
doi: 10.1016/j.ajic.2019.04.174
summary:
  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.

title:
  Health care workers’ perceptions and reported use of respiratory protective equipment: A qualitative analysis

abstract:
  BACKGROUND: Little is known about health care workers’ (HCW) perceptions of, or experiences using, respiratory protective equipment (RPE). We sought to characterize their perceptions and identify reasons underlying inappropriate use. METHODS: We conducted 12 focus groups with nurses and nursing assistants at 4 medical centers. We analyzed the thematic content of 73 discrete “stories” told by focus group participants. 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. DISCUSSION: HCWs were aware of the importance of RPE and protocols for using it, and these supported use when protocol lapses occurred. However, protocol adherence was undermined by clinical experience, perceived risk, and the distinct context of the emergency department where patients continually arrive with incomplete or delayed diagnoses. CONCLUSIONS: Protocols, visual cues, and social norms contribute to a culture of safety. This culture can be undermined when HCWs experience diagnostic uncertainty or they mistrust the protocol and instead rely on their clinical experiences.


id: cord-267860-mc0xa5om
author: Lam, Simon C.
date: 2016-05-01
txt: ./txt/cord-267860-mc0xa5om.txt
cache: ./cache/cord-267860-mc0xa5om.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0196655315012614
doi: 10.1016/j.ajic.2015.12.013
summary:
  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.

title:
  Evaluation of the user seal check on gross leakage detection of 3 different designs of N95 filtering facepiece respirators

abstract:
  BACKGROUND: The use of N95 respirators prevents spread of respiratory infectious agents, but leakage hampers its protection. Manufacturers recommend a user seal check to identify on-site gross leakage. However, no empirical evidence is provided. Therefore, this study aims to examine validity of a user seal check on gross leakage detection in commonly used types of N95 respirators. METHODS: A convenience sample of 638 nursing students was recruited. On the wearing of 3 different designs of N95 respirators, namely 3M-1860s, 3M-1862, and Kimberly-Clark 46827, the standardized user seal check procedure was carried out to identify gross leakage. Repeated testing of leakage was followed by the use of a quantitative fit testing (QNFT) device in performing normal breathing and deep breathing exercises. Sensitivity, specificity, predictive values, and likelihood ratios were calculated accordingly. RESULTS: As indicated by QNFT, prevalence of actual gross leakage was 31.0%-39.2% with the 3M respirators and 65.4%-65.8% with the Kimberly-Clark respirator. Sensitivity and specificity of the user seal check for identifying actual gross leakage were approximately 27.7% and 75.5% for 3M-1860s, 22.1% and 80.5% for 3M-1862, and 26.9% and 80.2% for Kimberly-Clark 46827, respectively. Likelihood ratios were close to 1 (range, 0.89-1.51) for all types of respirators. CONCLUSIONS: The results did not support user seal checks in detecting any actual gross leakage in the donning of N95 respirators. However, such a check might alert health care workers that donning a tight-fitting respirator should be performed carefully.


id: cord-270909-wb7mwklo
author: Cheng, Vincent C.C.
date: 2020-05-24
txt: ./txt/cord-270909-wb7mwklo.txt
cache: ./cache/cord-270909-wb7mwklo.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0196655320302807?v=s5
doi: 10.1016/j.ajic.2020.05.018
summary:
  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] .

title:
  Absence of nosocomial transmission of coronavirus disease 2019 (COVID-19) due to SARS-CoV-2 in the pre-pandemic phase in Hong Kong

abstract:
  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. METHODS: Administrative support with the aim of zero nosocomial transmission by reducing elective clinical services, decanting wards, mobilizing isolation facilities, providing adequate personal protective equipment, coordinating laboratory network for rapid molecular diagnosis under 4-tier active surveillance for hospitalized- and out-patients, and organizing staff forum and training was implemented under the framework of preparedness plan in Hospital Authority. The trend of SARS-CoV-2 in the first 72 days was compared with that of SARS-CoV 2003. RESULTS: Up to day 72 of the epidemic, 130 (0.40%) of 32,443 patients being screened confirmed to have SARS-CoV-2 by RT-PCR. Compared with SARS outbreak in 2003, the SARS-CoV-2 case load constituted 8.9% (130 SARS-CoV-2/1458 SARS-CoV) of SARS-CoV infected cases at day 72 of the outbreak. The incidences of nosocomial acquisition of SARS-CoV per-1,000-SARS-patient-day and per-100-SARS-patient-admission were 7.9 and 16.9 respectively, which were significantly higher than the corresponding incidences of SARS-CoV-2 (zero infection, p<0.001). CONCLUSION: Administrative support to infection control could minimize the risk of nosocomial transmission of SARS-CoV-2.


id: cord-271187-rlevoj41
author: Vijh, Rohit
date: 2020-10-18
txt: ./txt/cord-271187-rlevoj41.txt
cache: ./cache/cord-271187-rlevoj41.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/33086096/
doi: 10.1016/j.ajic.2020.10.009
summary:
  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.

title:
  Serological Survey following SARS-COV-2 Outbreaks at Long Term Care Facilities in Metro Vancouver, British Columbia: Implications for Outbreak Management and Infection Control Policies

abstract:
  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. Among individuals with a negative or no previous COVID-19 diagnostic test, myalgias, headache and loss of appetite were associated with serological reactivity. The US CDC probable case definition was also associated with seropositivity. Public health and infection control practitioners should consider these findings for case exclusion in outbreak settings.


id: cord-273531-q9ah287w
title: Characteristics of COVID-19 Near China''s Epidemic Center
author: Li, Yang
date: 2020-06-26
txt: ./txt/cord-273531-q9ah287w.txt
cache: ./cache/cord-273531-q9ah287w.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32599100/
doi: 10.1016/j.ajic.2020.06.191
summary:
  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.

abstract:
  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 main sources of infection were firsthand or secondhand exposure in Hubei Province and contact with confirmed cases, which mostly involved contact with infected household members. The mean periods from disease onset to first medical visit, first visit to final diagnosis, and final diagnosis to recovery were 4.44, 3.18, and 13.42 days, respectively. Conclusions: The results suggest that the measures taken to control the rate of infection were effective. Prevention and control efforts should respond as quickly as possible, isolate and control activities of individuals leaving infected areas, and restrict household contact transmission.


id: cord-273604-0w5shxmf
title: Halting a SARS-CoV-2 Outbreak in a U.S. Veterans Affairs Nursing Home
author: Psevdos, George
date: 2020-11-03
txt: ./txt/cord-273604-0w5shxmf.txt
cache: ./cache/cord-273604-0w5shxmf.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0196655320309640
doi: 10.1016/j.ajic.2020.10.022
summary:
  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

abstract:
  A Veterans Affairs long term care facility on Long Island New York was confronted with a COVID-19 outbreak in late March to Mid-April 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. It was a multidisciplinary team approach led by the Infection Control team that successfully contained this outbreak.


id: cord-273748-xy4f5kon
author: Armijo, Priscila R.
date: 2020-08-04
txt: ./txt/cord-273748-xy4f5kon.txt
cache: ./cache/cord-273748-xy4f5kon.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0196655320307628?v=s5
doi: 10.1016/j.ajic.2020.07.037
summary:
  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.

title:
  3D Printing of Face Shields to Meet the Immediate Need for PPE in an Anesthesiology Department during the COVID-19 Pandemic

abstract:
  Anesthesia providers are at risk for contracting COVID-19 due close patient contact. Proper personal protective equipment (PPE) use is critical to providing a safe environment and to minimize the risk of contagion. During the COVID-19 Pandemic, a series of supply chain issues, constant changes in PPE use policy, and higher demand for PPE led to shortages in PPE, specifically N95 masks and face shields. Implementation of decontamination protocols successfully allowed N95 mask reuse but, required masks to be unsoiled. Face shields not only act as a barrier against the soiling of N95 face masks, they also serve as more effective eye protection from respiratory droplets over standard eye shields. The University of Nebraska Medical Center produced face shields using a combination of 3D printing and assembly with commonly available products. Approximately 112 face shields were constructed and made available for use in 72 hours. Importantly, we created and implemented a simple but effective decontamination protocol, which allowed reuse of the face shields. These methods were successfully implemented for in-house production of face shields used at Tripler Army Medical Center (Tripler AMC, Hawaii). The effectiveness of the decontamination protocol was evaluated using the average log(10) reduction in colony counts for Escherichia coli ATCC 8937 and Staphylococcus aureus ATCC 25923 from the American Type Culture Collection (ATCC, Manassas, VA). In this manuscript, we present our detailed protocol and supplies needed for printing 3D face shields to enable the rapid production of this product by individuals with little to no 3D printing experience, in times of urgent need.


id: cord-275552-ijxxeo27
author: Yen, Zui-Shen
date: 2007-10-10
txt: ./txt/cord-275552-ijxxeo27.txt
cache: ./cache/cord-275552-ijxxeo27.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/17936142/
doi: 10.1016/j.ajic.2006.09.008
summary:
  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).

title:
  How much would you be willing to pay for preventing a new dangerous infectious disease: A willingness-to-pay study in medical personnel working in the emergency department

abstract:
  BACKGROUND: The risk of developing nosocomial infectious diseases among medical personnel in the emergency department (ED) can result in tremendous psychologic stress. 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). METHODS: A contingent valuation approach with close-ended format was used. During the study period from June 15, 2003 through June 30, 2003, a convenience sample of all medical personnel working in the ED of National Taiwan University Hospital was carried out. Participants were interviewed by a standard questionnaire and were asked to choose whether or not they would pay at a specified price to purchase a hypothetical SARS vaccine. A logistic regression model was created to evaluate the relationship between willingness-to-pay and the log of the price offered in the bid questions. The median and mean amounts of willingness-to-pay were calculated. RESULTS: A total of 115 subjects were interviewed and most were nurses (68.7%). The median and mean amount subjects reported being willing to pay for a SARS vaccine was US $1762 and US $720, respectively. Subject responses were significantly related to the price of vaccination and their type of job. CONCLUSIONS: Medical personnel in the ED reported that they would be willing to pay substantial monetary amounts for preventing nosocomial SARS.


id: cord-275997-4ibeidyw
title: The practice of infection control and applied epidemiology: A historical perspective
author: Goldrick, Barbara A.
date: 2005-10-31
txt: ./txt/cord-275997-4ibeidyw.txt
cache: ./cache/cord-275997-4ibeidyw.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0196655305007388
doi: 10.1016/j.ajic.2005.04.250
summary:
  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.

abstract:
  The United States health care system and patient populations have changed substantially over the past several decades. The practice of infection control also has evolved since the landmark Study on the Efficacy of Nosocomial Infection Control project, and infection control professionals (ICPs) must continue to develop the knowledge and skills necessary to practice infection prevention and control. Practice analyses of infection control conducted between 1982 and 2001 were analyzed to determine changes in practice. These data reflect a 145% increase in infection control activities over a 20-year period. However, resources for infection control and prevention have not kept pace with this increased activity. 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 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.


id: cord-276758-k2imddzr
author: Siegel, Jane D.
date: 2007-12-07
txt: ./txt/cord-276758-k2imddzr.txt
cache: ./cache/cord-276758-k2imddzr.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/18068815/
doi: 10.1016/j.ajic.2007.10.007
abstract: nan
summary:
  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.

title:
  2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Health Care Settings


id: cord-278592-67y4f9av
title: Control of a hospital-wide vancomycin-resistant Enterococci outbreak
author: Kurup, Asok
date: 2008-03-24
txt: ./txt/cord-278592-67y4f9av.txt
cache: ./cache/cord-278592-67y4f9av.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0196655307007195
doi: 10.1016/j.ajic.2007.06.005
summary:
  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.

abstract:
  BACKGROUND: To analyze control measures used to eradicate a large vancomycin-resistant Enterococci (VRE) outbreak in a nonendemic 1600-bed tertiary care institution. METHODS: In mid-March 2005, VRE Van B was isolated from 2 clinical samples from different wards. Despite such measures as screening patients sharing rooms with index cases and isolating VRE patients, 43 isolates from different wards were detected by the end of March 2005. 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. This is a retrospective study of this multipronged approach to containing VRE. The adequacy of rectal swab sampling for VRE was assessed in a substudy of 111 patients. The prevalence of methicillin-resistant Staphylococcus aureus (MRSA)/VRE co-colonization or co-infection also was determined. RESULTS: A total of 19,574 contacts were identified. Between April and June 2005, 5095 patients were screened, yielding 104 VRE carriers, 54 of whom (52%) were detected in the first 2 weeks of hospital-wide screening. The initial positive yield of 11.4% of persons actively screened declined to 4.2% by the end of June 2005. Pulsed-field typing revealed 1 major clone and several minor clones among the 151 total VRE cases, including 4 clinical cases. Hospital-wide physical segregation of contacts from other patients was difficult to achieve in communal wards. Co-colonization or co-infection with MRSA, which was present in 52 of 151 cases (34%) and the indefinite electronic tagging of positive VRE status strained limited isolation beds. Analysis of 2 fecal or rectal specimens collected 1 day apart may detect at least 83% of VRE carriers. CONCLUSION: A multipronged strategy orchestrated by a central task force curbed but could not eradicate VRE. Control measures were confounded by hospital infrastructure and high MRSA endemicity.


id: cord-279640-n391v32y
author: Atreja, Ashish
date: 2008-03-26
txt: ./txt/cord-279640-n391v32y.txt
cache: ./cache/cord-279640-n391v32y.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.ajic.2008.01.002
doi: 10.1016/j.ajic.2008.01.002
abstract: nan
summary:
  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.

title:
  Opportunities and challenges in utilizing electronic health records for infection surveillance, prevention, and control


id: cord-282272-wy8do2z6
author: Nelson, Atiba
date: 2020-07-06
txt: ./txt/cord-282272-wy8do2z6.txt
cache: ./cache/cord-282272-wy8do2z6.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S019665532030643X
doi: 10.1016/j.ajic.2020.07.001
summary:
  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.

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

abstract:
  We conducted environmental sampling at long-term care facilities to determine the extent of surface contamination with SARS-CoV-2 virus. Medical equipment used throughout the facility was determined to be contaminated.


id: cord-285849-jg43tcfh
title: Universal SARS preventive measures in an obstetrics unit: Experience of health care staff
author: Chan, Ben Chong Pun
date: 2004-10-30
txt: ./txt/cord-285849-jg43tcfh.txt
cache: ./cache/cord-285849-jg43tcfh.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0196655304004092
doi: 10.1016/j.ajic.2004.01.006
summary:
  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.

abstract:
  BACKGROUND: Severe acute respiratory syndrome (SARS) epidemics have affected populations in many countries, including Hong Kong. This disease is infectious, especially in hospital settings. Health care workers have expressed great concern, including those working in obstetrics wards, defined as high-risk areas. 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. In addition, respondents were generally dissatisfied with the measures, as most items imposed extra work, inconvenience, and burdens on the staff. CONCLUSION: Our findings reported the views and satisfaction levels of the front-line staff of an obstetric unit concerning precautionary measures against SARS. The importance of individualized design and implementation of infection control measures is highlighted and discussed.


id: cord-288589-bt9429bh
title: Hadj ritual and risk of a pandemic
author: Habibzadeh, Farrokh
date: 2013-12-31
txt: ./txt/cord-288589-bt9429bh.txt
cache: ./cache/cord-288589-bt9429bh.txt
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mime: text/plain
url: https://doi.org/10.1016/j.ajic.2013.08.011
doi: 10.1016/j.ajic.2013.08.011
abstract: nan
summary:
  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


id: cord-290257-2u228xe9
author: Hsu, Chih-Cheng
date: 2006-05-05
txt: ./txt/cord-290257-2u228xe9.txt
cache: ./cache/cord-290257-2u228xe9.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0196655306000794
doi: 10.1016/j.ajic.2005.11.008
summary:
  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.

title:
  Confidence in controlling a SARS outbreak: Experiences of public health nurses in managing home quarantine measures in Taiwan

abstract:
  BACKGROUND: Taiwan experienced one of the most serious outbreaks of severe acute respiratory syndrome (SARS) during the 2003 epidemic. Public health nurses faced unprecedented challenges in implementing an extensive quarantine policy to prevent disease spread. Their professional confidence, however, was shattered during the SARS crisis. This paper assesses factors related to public health nurses' confidence in managing community SARS control programs. METHODS: In May 2003, we sent structured questionnaires to all 361 health centers in Taiwan and asked the public health nurses responsible for epidemic control to complete. A total of 312 completed surveys were returned for a response rate of 86.4%. Descriptive methods and logistic regression were used to analyze the data. RESULTS: Most public health nurses (71.9%) expressed a general lack of confidence in handling the SARS epidemic. Confidence was significantly associated with perceived epidemic severity (OR, 0.58; 95% CI: 0.35-0.99), daily epidemic updates (OR, 2.26; 95% CI: 1.28-3.98), and number of cases in the community (OR, 2.21; 95% CI: 1.13-4.31). CONCLUSION: Nurses' individual risk perception and prompt update of epidemic information significantly affect levels of professional confidence, a key factor influencing quarantine implementation success. Strategies to promote productive interagency collaboration and advocate participatory policy making involving health workers at all levels are needed to control effectively infectious disease outbreaks.


id: cord-290441-r4tzodkj
author: Iversen, Anne-Mette
date: 2020-11-10
txt: ./txt/cord-290441-r4tzodkj.txt
cache: ./cache/cord-290441-r4tzodkj.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0196655320309913
doi: 10.1016/j.ajic.2020.11.007
summary:
  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).

title:
  Light-guided nudging and data-driven performance feedback improve hand hygiene compliance among nurses and doctors

abstract:
  BACKGROUND: Evidence-based practices to increase hand hygiene compliance (HHC) among healthcare workers are warranted. We aimed to investigate the effect of a multimodal strategy on HHC. METHODS: During this 14-months prospective, observational study, an automated monitoring system was implemented in a 29-beds surgical ward. Hand hygiene opportunities and alcohol-based hand rubbing events were measured in patient and working rooms (medication, utility, storerooms, toilets). We compared baseline HHC of healthcare workers across periods with light-guided nudging from sensors on dispensers and data-driven performance feedback (multimodal strategy) using the Student's t-test. RESULTS: The doctors (n=10) significantly increased their HHC in patient rooms (16% vs. 42%, p<0.0001) and working rooms (24% vs. 78%, p=0.0006) when using the multimodal strategy. The nurses (n=26) also increased their HHC significantly from baseline in both patient rooms (27% vs. 43%, p=0.0005) and working rooms (39% vs. 64%, p<0.0001). The nurses (n=9), who subsequently received individual performance feedback, further increased HHC, compared with the period when they received group performance feedback (patient rooms: 43% vs. 55%, p<0.0001 and working rooms: 64% vs. 80%, p<0.0001). 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.


id: cord-290961-wbdfcaup
author: Khan, Dr Shahrukh
date: 2020-10-02
txt: ./txt/cord-290961-wbdfcaup.txt
cache: ./cache/cord-290961-wbdfcaup.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/33017627/
doi: 10.1016/j.ajic.2020.09.012
summary:
  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.

title:
  Comparative accuracy testing of non-contact infrared thermometers and temporal artery thermometers in an adult hospital setting

abstract:
  BACKGROUND: NCIT are non-invasive devices for fever screening in children. However, evidence of their accuracy for fever screening in adults is lacking. This study aimed to compare the accuracy of non-contact infrared thermometers (NCIT) with temporal artery thermometers (TAT) in an adult hospital. METHODS: A prospective observational study was conducted on a convenience sample of non-infectious inpatients in two Australian hospitals. NCIT and TAT devices were used to collect body temperature recordings. Participant characteristics included age, gender, skin colour, highest temperature and antipyretic medications recorded in last 24-hours. 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. Bland-Altman analysis showed that NCIT and TAT temperatures were closely aligned at temperatures <37.5°C, but not at temperatures >37.5°C. NCIT had low sensitivity (16.13%) at temperatures ≥37.5°C. An AUROC score of 0.67 (SD 0.05) demonstrated poor accuracy of the NCIT device at temperatures ≥37.5°C. CONCLUSION: This is the first study to compare accuracy of NCIT thermometers to TAT in adult patients. Although mass fever screening is currently underway using NCIT, these results indicate that the NCIT may not be the most accurate device for fever mass screening during a pandemic.


id: cord-291650-1qy6y7f0
author: Butt, Taimur S.
date: 2016-05-01
txt: ./txt/cord-291650-1qy6y7f0.txt
cache: ./cache/cord-291650-1qy6y7f0.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/26922892/
doi: 10.1016/j.ajic.2016.01.004
summary:
  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.

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

abstract:
  BACKGROUND: Transmission of Middle East respiratory syndrome-coronavirus (MERS-CoV) among health care workers (HCWs) and patients has been documented with mortality rate approximating 36%. We propose advanced infection control measures (A-IC) used in conjunction with basic infection control measures (B-IC) help reduce pathogen transmission. B-IC include standard and transmission-based precautions. A-IC are initiatives implemented within our center to enhance effectiveness of B-IC. OBJECTIVE: Study effectiveness of combining B-IC and A-IC to prevent transmission of MERS-CoV to HCWs. METHODS: A retrospective observational study was undertaken. 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. RESULTS: A total of 874 real-time polymerase chain reaction MERS-CoV tests were performed during the period beginning July 1, 2013, and ending January 31, 2015. Six hundred ninety-four non-HCWs were tested, of these 16 tested positive for MERS-CoV and their infection was community acquired. Sixty-nine percent of the confirmed MERS-CoV-positive cases were men, with an average age of 56 years (range, 19-84 years). Of the total tested for MERS-CoV, 180 individuals were HCWs with zero positivity. CONCLUSIONS: Adhering to a combination of B-IC and A-IC reduces the risk of MERS-CoV transmission to HCWs.


id: cord-291679-jfxqipt8
author: Yang, Seongwoo
date: 2017-06-01
txt: ./txt/cord-291679-jfxqipt8.txt
cache: ./cache/cord-291679-jfxqipt8.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0196655317301347
doi: 10.1016/j.ajic.2017.02.013
summary:
  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.

title:
  Middle East respiratory syndrome risk perception among students at a university in South Korea, 2015

abstract:
  BACKGROUND: The 2015 Middle East respiratory syndrome (MERS) outbreak in South Korea was a serious threat to public health, and was exacerbated by the inappropriate responses of major institutions and the public. This study examined the sources of confusion during the MERS outbreak and identified the factors that can affect people's behavior. METHODS: An online survey of the risk perception of university students in South Korea was performed after the epidemic had peaked. The questionnaire addressed the major social determinants in South Korea during the MERS epidemic. The analysis included data from 1,470 subjects who provided complete answers. RESULTS: The students had 53.5% of the essential knowledge about MERS. Women showed higher risk perception than men, and trust in the media was positively associated with risk perception (P < .001). Additionally, risk perception was positively associated with overreaction by the public (odds ratio, 2.80; 95% confidence interval, 2.17-3.60; P < .001). These findings suggest that media content affected the public's perception of MERS risk and that perception of a high level of risk led to overreaction. CONCLUSIONS: Risk perception was associated with most of the social factors examined and overreaction by the public. Therefore, providing accurate information and data to the public, establishing trust, and facilitating the development of an attitude will all be important in future crises.


id: cord-291742-donflx7w
author: Khan, Raymond M.
date: 2018-09-05
txt: ./txt/cord-291742-donflx7w.txt
cache: ./cache/cord-291742-donflx7w.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.ajic.2018.06.022
doi: 10.1016/j.ajic.2018.06.022
summary:
  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).

title:
  Implementing the comprehensive unit-based safety program model to improve the management of mechanically ventilated patients in Saudi Arabia

abstract:
  BACKGROUND: Ventilator-associated events are common in mechanically ventilated patients. They are associated with more days on mechanical ventilation, longer intensive care unit (ICU) stay, and increased risk of mortality. Theoretically, interventions that prevent ventilator-associated events should also reduce associated morbidity. We evaluated the Comprehensive Unit-based Safety Program approach to improve the care of mechanically ventilated patients. METHODS: All mechanically ventilated patients admitted to the ICU between October 1, 2015, and October 31, 2016, were prospectively monitored for the development of ventilator-associated events according to the National Healthcare Safety Network criteria. A process care bundle (endotracheal intubation with subglottic suctioning, head-of-bed elevation ≥30°, target sedation scores, daily spontaneous awakening trials, spontaneous breathing trials), daily delirium assessment, and an early mobility protocol were instituted. The bundle compliance, ventilator-associated events rates, ICU length of stay, and mortality rate were noted. The database allowed viewing of current rates, trends, and averages of all participating sites. RESULTS: In the study period, 2,321 patients were admitted to the ICU, and 1,231 required mechanical ventilation (10,342 ventilator days). There were 115 ventilator-associated events: 82 ventilator-associated conditions, 15 infection-related ventilator-associated conditions, and 18 possible cases of ventilator-associated pneumonia. The ICU mortality rate was 13.3%, compared with 28.7% for those mechanically ventilated patients with ventilator-associated events (P = .0001). There was increased compliance for spontaneous awakening trials (51.5%-76.9%, P = .0008) and spontaneous breathing trials (54.2%-72.2%, P = .02) and a decrease in infection-related ventilator-associated conditions (4.2-3.5 per 1,000 days), possible cases of ventilator-associated pneumonia (2.1-1.7 per 1,000 days), ICU mortality (45.3%-19.1%, P = .045), and ventilator-associated events associated mortality rates (33.3%-8.3%, P < .37). Physical therapy participation and mobility were 60.8% and 26.4%, respectively. CONCLUSION: The implementation of a multipronged program like the Comprehensive Unit-based Safety Program could improve the care processes and outcomes of mechanically ventilated patients.


id: cord-292981-7qbi7wqr
author: Memarzadeh, Farhad
date: 2010-06-07
txt: ./txt/cord-292981-7qbi7wqr.txt
cache: ./cache/cord-292981-7qbi7wqr.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/20569852/
doi: 10.1016/j.ajic.2010.04.208
summary:
  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.

title:
  Applications of ultraviolet germicidal irradiation disinfection in health care facilities: Effective adjunct, but not stand-alone technology

abstract:
  This review evaluates the applicability and relative contribution of ultraviolet germicidal irradiation (UVGI) to disinfection of air in health care facilities. A section addressing the use of UVGI for environmental surfaces is also included. The germicidal susceptibility of biologic agents is addressed, but with emphasis on application in health care facilities. The balance of scientific evidence indicates that UVGI should be considered as a disinfection application in a health care setting only in conjunction with other well-established elements, such as appropriate heating, ventilating, and air-conditioning (HVAC) systems; dynamic removal of contaminants from the air; and preventive maintenance in combination with through cleaning of the care environment. We conclude that although UVGI is microbiocidal, it is not “ready for prime time” as a primary intervention to kill or inactivate infectious microorganisms; rather, it should be considered an adjunct. Other factors, such as careful design of the built environment, installation and effective operation of the HVAC system, and a high level of attention to traditional cleaning and disinfection, must be assessed before a health care facility can decide to rely solely on UVGI to meet indoor air quality requirements for health care facilities. More targeted and multiparameter studies are needed to evaluate the efficacy, safety, and incremental benefit of UVGI for mitigating reservoirs of microorganisms and ultimately preventing cross-transmission of pathogens that lead to health care-associated infections.


id: cord-295469-5an7836u
author: Ijaz, M. Khalid
date: 2016-09-02
txt: ./txt/cord-295469-5an7836u.txt
cache: ./cache/cord-295469-5an7836u.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.ajic.2016.06.008
doi: 10.1016/j.ajic.2016.06.008
summary:
  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) .

title:
  Generic aspects of the airborne spread of human pathogens indoors and emerging air decontamination technologies

abstract:
  Indoor air can be an important vehicle for a variety of human pathogens. This review provides examples of airborne transmission of infectious agents from experimental and field studies and discusses how airborne pathogens can contaminate other parts of the environment to give rise to secondary vehicles leading air-surface-air nexus with possible transmission to susceptible hosts. 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). An overview of methods for experimentally generating and recovering airborne human pathogens is included, along with a discussion of factors that influence microbial survival in indoor air. Available guidelines from the U.S. Environmental Protection Agency and other global regulatory bodies for the study of airborne pathogens are critically reviewed with particular reference to microbial surrogates that are recommended. Recent developments in experimental facilities to contaminate indoor air with microbial aerosols are presented, along with emerging technologies to decontaminate indoor air under field-relevant conditions. Furthermore, the role that air decontamination may play in reducing the contamination of environmental surfaces and its combined impact on interrupting the risk of pathogen spread in both domestic and institutional settings is discussed.


id: cord-295733-f3rt1fyk
title: Evaluation of disinfection procedures in a designated hospital for COVID-19
author: Ge, Tianxiang
date: 2020-08-22
txt: ./txt/cord-295733-f3rt1fyk.txt
cache: ./cache/cord-295733-f3rt1fyk.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0196655320308129?v=s5
doi: 10.1016/j.ajic.2020.08.028
summary:
  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

abstract:
  BACKGROUND: Coronavirus disease 2019 (COVID-19) has spread globally and been a public health emergency worldwide. It is important to reduce the risk of healthcare associated infections among the healthcare workers and patients. This study aimed to investigate the contamination of environment in isolation wards and sewage, and assess the quality of routine disinfection procedures in our hospital. METHODS: Routine disinfection procedures were performed three-times a day in general isolation wards and six-times a day in isolated ICU wards in our hospital. Environmental surface samples and sewage samples were collected for viral RNA detection. SARS-CoV-2 RNA detection were performed with quantitative reverse transcription PCR (qRT-PCR). RESULTS: A total of 163 samples were collected from February 6th to April 4th. Among 122 surface samples, two were positive for SARS-CoV-2 RNA detection. One was collected from the flush button of the toilet bowl, and the other was collected from a hand-basin. Although 10 of the sewage samples were positive for viral RNA detection, all positive samples were negative for viral culture. CONCLUSION: These results revealed the routine disinfection procedures in our hospital were effective in reducing the potential risk of healthcare associated infection. Two surface samples were positive for viral detection, suggesting that more attention should be paid when disinfecting places easy to be ignored.


id: cord-297462-c5hafan8
author: Tang, Lu
date: 2018-06-19
txt: ./txt/cord-297462-c5hafan8.txt
cache: ./cache/cord-297462-c5hafan8.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.ajic.2018.05.019
doi: 10.1016/j.ajic.2018.05.019
summary:
  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.

title:
  Tweeting about measles during stages of an outbreak: A semantic network approach to the framing of an emerging infectious disease

abstract:
  BACKGROUND: The public increasingly uses social media not only to look for information about emerging infectious diseases (EIDs), but also to share opinions, emotions, and coping strategies. Identifying the frames used in social media discussion about EIDs will allow public health agencies to assess public opinions and sentiments. 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. RESULTS: Four frames were identified based on word frequencies and co-occurrence: news update, public health, vaccination, and political. The prominence of each individual frame changed over the corse of the pre-crisis, initial, maintenance, and resolution stages of the outbreak. CONCLUSIONS: This study proposed and tested a method for assessing the frames used in social media discussions about EIDs based on the creation, interpretation, and quantification of semantic networks. Public health agencies could use social media outlets, such as Twitter, to assess how the public makes sense of an EID outbreak and to create adaptive messages in communicating with the public during different stages of the crisis.


id: cord-299475-p6cc98xa
title: Exploring determinants of acceptance of the pandemic influenza A (H1N1) 2009 vaccination in nurses
author: To, Kin-Wang
date: 2010-06-20
txt: ./txt/cord-299475-p6cc98xa.txt
cache: ./cache/cord-299475-p6cc98xa.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.ajic.2010.05.015
doi: 10.1016/j.ajic.2010.05.015
summary:
  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.

abstract:
  This study investigated the anticipated vaccination rate against pandemic human influenza A (H1N1) 2009 in the health care setting. Self-administered questionnaires were used to assess nurses' acceptance of vaccination against seasonal flu and H1N1. They were sent to nurses by post through various nurses' unions before initiation of the vaccination program. Only 13.3% of the respondents planned to receive the H1N1 vaccine, compared with 37.5% for the seasonal influenza vaccine. Vaccination against seasonal influenza in the preceding season strongly predicted the likelihood of H1N1 vaccination. The main reason cited for H1N1 vaccination was self-protection, and reasons for rejecting vaccination included possible side effects, ineffectiveness of the vaccine, and the mild nature of the disease. Personal contact with patients with H1N1 or severe acute respiratory syndrome at work did not significantly increase the likelihood of receiving the H1N1 vaccine. More than 40% of the respondents were undecided at the time of the survey. The promotion of vaccination against seasonal influenza may play a role in improving H1N1 vaccination coverage. Efforts are needed to address concerns about vaccination risk and to incorporate H1N1 vaccination in standard infection control practice with policy support.


id: cord-300754-q356npb7
author: Choi, Hye-Suk
date: 2017-05-01
txt: ./txt/cord-300754-q356npb7.txt
cache: ./cache/cord-300754-q356npb7.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.ajic.2017.01.009
doi: 10.1016/j.ajic.2017.01.009
summary:
  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.

title:
  Laboratory-based surveillance of hospital-acquired respiratory virus infection in a tertiary care hospital

abstract:
  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. Rhinovirus was the most common virus (30.3%), followed by influenza virus (17.6%) and parainfluenza virus (15.6%).


id: cord-301988-cevv81h3
author: Hassoun, Ali
date: 2015-08-01
txt: ./txt/cord-301988-cevv81h3.txt
cache: ./cache/cord-301988-cevv81h3.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/26052103/
doi: 10.1016/j.ajic.2015.04.195
summary:
  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.

title:
  Seasonal variation of respiratory pathogen colonization in asymptomatic health care professionals: A single-center, cross-sectional, 2-season observational study

abstract:
  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. METHODS: Nasopharyngeal specimens from 100 HCPs were collected from Huntsville Hospital (Huntsville, AL) during the winter and from 100 HCPs during the summer. All subjects were tested for 22 viruses and 19 bacteria using Target Enriched Multiplex Polymerase Chain Reaction. Both seasonal cohorts were composed of students, nurses, physicians, and residents. RESULTS: Of the 100 HCPs tested during the winter, 34 subjects were colonized with at least 1 bacterium, and 11 tested positive for at least 1 virus. Methicillin-resistant Staphylococcus aureus (MRSA), Moraxella catarrhalis, and coronavirus were the most frequently detected potentially infectious agents. Of the 100 HCPs tested during the summer, 37 tested positive for at least 1 bacterium, and 4 tested positive for a viral agent. The most prevalent bacteria were MRSA and Klebsiella pneumonia. CONCLUSION: Nasopharyngeal carriage among asymptomatic HCPs was common, but the frequency and presence of potential pathogens varied with each season. Understanding the colonization and infection potential of upper respiratory organisms is important, particularly for viruses. 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.


id: cord-302103-mwlgvuag
author: Higgins, Wayne
date: 2004-09-27
txt: ./txt/cord-302103-mwlgvuag.txt
cache: ./cache/cord-302103-mwlgvuag.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/15454888/
doi: 10.1016/j.ajic.2004.03.006
summary:
  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.

title:
  Assessing hospital preparedness using an instrument based on the Mass Casualty Disaster Plan Checklist: Results of a statewide survey

abstract:
  BACKGROUND: Hospitals would play a critical role in a weapon of mass destruction (WMD) event. The purpose of this study is to assess preparedness for mass casualty events in short-term and long-term hospitals in Kentucky. 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. RESULTS: Responses were received from 116 of the 118 (98%) hospitals surveyed. Hospitals reported surge capacity equal to 27% of licensed beds, and virtually all respondents were engaged in planning for weapons of mass destruction events. However, advanced planning and preparation were less common. Large regional differences were observed, especially in the area of pharmaceutical planning. Preparedness planning in general and pharmaceutical management planning in particular were more advanced in counties participating in the Metropolitan Medical Response System Program (MMRS). CONCLUSIONS: Hospital mass casualty preparedness efforts were in an early stage of development at the time of this survey, and some critical capabilities, such as isolation, decontamination, and syndromic surveillance were clearly underdeveloped. Preparedness planning was more advanced among hospitals located in MMRS counties.


id: cord-302761-yila2wht
title: Disposable versus Reusable Medical Gowns: A Performance Comparison
author: McQuerry, Meredith
date: 2020-10-20
txt: ./txt/cord-302761-yila2wht.txt
cache: ./cache/cord-302761-yila2wht.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.ajic.2020.10.013
doi: 10.1016/j.ajic.2020.10.013
summary:
  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.

abstract:
  BACKGROUND: Medical gowns are essential personal protective equipment (PPE) that prevent the spread of microorganisms and bodily fluids. During surge capacity situations, such as the COVID-19 pandemic, reusable PPE is often recommended due to shortages. METHODS: This research evaluated the performance of disposable versus reusable medical gowns by assessing their ability to provide adequate protection across their expected service lifespan. 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. Data was collected at new for the disposable gowns and after 1, 25, 50, and 75 industrial launderings for the reusable gowns. Results were compared to AAMI PB70 performance specifications. RESULTS: Level I and II disposable gowns did not meet AAMI performance specifications for impact penetration water resistance. All three levels of disposable gowns also failed to meet ASTM performance requirements for breaking strength in the crosswise direction. CONCLUSIONS: The adoption of reusable gowns may result in increased protection and significant cost savings due to their superior durability and sustainability when compared to disposable gowns.


id: cord-303685-sxsrz60h
title: Zinc pyrithione in alcohol-based products for skin antisepsis: Persistence of antimicrobial effects
author: Guthery, Eugene
date: 2005-01-29
txt: ./txt/cord-303685-sxsrz60h.txt
cache: ./cache/cord-303685-sxsrz60h.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S019665530400570X
doi: 10.1016/j.ajic.2004.07.012
summary:
  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.

abstract:
  Alcohol-based products for skin antisepsis have a long history of safety and efficacy in the United States and abroad. However, alcohol alone lacks the required antimicrobial persistence to provide for the sustained periods of skin antisepsis desired in the clinical environment. Therefore, alcohol-based products must have a preservative agent such as iodine/iodophor compounds, chlorhexidine gluconate, or zinc pyrithione, to extend its antimicrobial effects. Iodine, iodophors, and chlorhexidine gluconate are well-characterized antimicrobials and preservatives. The thrust of our effort was to examine the characteristics of the lesser-known zinc pyrithione and to evaluate its utility as a preservative in the formulation of alcohol-based products for skin antisepsis. 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. In addition, alcohol-based, zinc pyrithione-preserved, commercially available products of skin antisepsis are compared with other commercially available antimicrobials used for skin antisepsis and with additional alcohol-based products with different preservatives. 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.


id: cord-304124-ym9mf5wz
author: Li, Jia
date: 2020-06-12
txt: ./txt/cord-304124-ym9mf5wz.txt
cache: ./cache/cord-304124-ym9mf5wz.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0196655320303692?v=s5
doi: 10.1016/j.ajic.2020.06.008
summary:
  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.

title:
  Meta-analysis investigating the relationship between clinical features, outcomes, and severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia

abstract:
  OBJECTIVE: We aimed to investigate the relationship between clinical characteristics, outcomes and the 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. RESULTS: We included 12 cohort studies including 2445 patients with COVID-19. Compared with non-severe (non-ICU) patients, severe (ICU) disease was associated with a smoking history (P=0.003) and comorbidities including chronic obstructive pulmonary disease (OR=5.08, P<0.001), diabetes (OR=3.17, P<0.001), hypertension (OR=2.40, P<0.001), coronary heart disease (OR=2.66, P<0.001), cerebrovascular diseases (OR=2.68, P=0.008), and malignancy (OR=2.21, P=0.040). We found significant differences between the two groups for fever, dyspnea, decreased lymphocyte and platelet counts, and increased leukocyte count, C-creative protein, procalcitonin, lactose dehydrogenase, aspartate aminotransferase, alanine aminotransferase, creatinine kinase, and creatinine levels (P<0.05). Significant differences were also observed for multiple treatments (P<0.05). Patients in the severe (ICU) group were more likely to have complications and had a much higher mortality rate and lower discharge rate than those with non-severe (non-ICU) disease (P<0.05). CONCLUSIONS: Investigation of clinical characteristics and outcomes of severe cases of COVID-19 will contribute to early prediction, accurate diagnosis, and treatment to improve the prognosis of patients with severe illness.


id: cord-305048-y42o6exe
title: Chest tube with air leaks is a potential “super spreader” of COVID-19
author: Sugimoto, Hiroshi
date: 2020-06-05
txt: ./txt/cord-305048-y42o6exe.txt
cache: ./cache/cord-305048-y42o6exe.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0196655320303576?v=s5
doi: 10.1016/j.ajic.2020.06.001
abstract: nan
summary:
  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


id: cord-306646-6c7n0xir
title: Resumption of Respiratory Outpatient Services in the COVID-19 era: experience from Southern Italy
author: Crimi, Claudia
date: 2020-07-02
txt: ./txt/cord-306646-6c7n0xir.txt
cache: ./cache/cord-306646-6c7n0xir.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0196655320306337
doi: 10.1016/j.ajic.2020.06.210
summary:
  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.

abstract:
  COVID-19 pandemic turned the entire health-care system organization upside-down, suspending elective activities and outpatient services. In Italy, we are entering a second phase of the pandemic and several strategies has been developed to “re-open” the country, some businesses, and also health-care outpatient activities. This manuscript describes the experience of a Southern Italy Respiratory Unit for safely resuming outpatient respiratory services and preventing COVID-19 transmission.


id: cord-306930-tuositq1
title: Face touching: A frequent habit that has implications for hand hygiene
author: Kwok, Yen Lee Angela
date: 2015-02-01
txt: ./txt/cord-306930-tuositq1.txt
cache: ./cache/cord-306930-tuositq1.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0196655314012814
doi: 10.1016/j.ajic.2014.10.015
summary:
  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.

abstract:
  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. METHODS: A behavioral observation study was undertaken involving medical students at the University of New South Wales. Their face-touching behavior was observed via videotape recording. Using standardized scoring sheets, the frequency of hand-to-face contacts with mucosal or nonmucosal areas was tallied and analyzed. RESULTS: On average, each of the 26 observed students touched their face 23 times per hour. Of all face touches, 44% (1,024/2,346) involved contact with a mucous membrane, whereas 56% (1,322/2,346) of contacts involved nonmucosal areas. Of mucous membrane touches observed, 36% (372) involved the mouth, 31% (318) involved the nose, 27% (273) involved the eyes, and 6% (61) were a combination of these regions. 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. Hand hygiene programs aiming to improve compliance with before and after patient contact should include a message that mouth and nose touching is a common practice. Hand hygiene is therefore an essential and inexpensive preventive method to break the colonization and transmission cycle associated with self-inoculation.


id: cord-307263-znuqdzdp
title: A Qualitative Study on the Psychological Experience of Caregivers of COVID-19 Patients
author: Sun, Niuniu
date: 2020-04-08
txt: ./txt/cord-307263-znuqdzdp.txt
cache: ./cache/cord-307263-znuqdzdp.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0196655320302017?v=s5
doi: 10.1016/j.ajic.2020.03.018
summary:
  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.

abstract:
  BACKGROUND: The coronavirus disease 2019 (COVID-19) is spreading rapidly, bringing pressure and challenges to nursing staff. OBJECTIVE: To explore the psychology of nurses caring for COVID-19 patients. METHOD: Using a phenomenological approach, we enrolled 20 nurses who provided care for COVID-19 patients in the First Affiliated Hospital of Henan University of Science and Technology from 20 January to 10 February 2020. The interviews were conducted face-to-face or by telephone and were analysed by Colaizzi's 7-step method. RESULTS: The psychological experience of nurses caring for COVID-19 patients can be summarized into four themes. Firstly, negative emotions present in early stage consisting of fatigue, discomfort, and helplessness was caused by high-intensity work, fear and anxiety, and concern for patients and family members. Secondly, self-coping styles included psychological and life adjustment, altruistic acts, team support, and rational cognition. Thirdly, we found growth under pressure, which included increased affection and gratefulness, development of professional responsibility, and self-reflection. Finally, we showed that positive emotions occurred simultaneously with negative emotions. CONCLUSIONS: During an epidemic outbreak, positive and negative emotions of the front-line nurses interweaved and coexisted. In the early stage, negative emotions were dominant and positive emotions appeared gradually. Self-coping styles and psychological growth played an important role in maintaining mental health of nurses.


id: cord-308546-wlnbpgz7
title: An Evaluation of Cleaning Practices at a Teaching Hospital
author: Meyer, Julien
date: 2020-06-26
txt: ./txt/cord-308546-wlnbpgz7.txt
cache: ./cache/cord-308546-wlnbpgz7.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S019665532030568X?v=s5
doi: 10.1016/j.ajic.2020.06.187
summary:
  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.

abstract:
  BACKGROUND: The COVID-19 outbreak has highlighted the role of hospital-acquired infections in spreading epidemics. Adequately cleaning surfaces in patient rooms is an essential part of this fight to reduce the spread. Traditional audits, however, are insufficient. This study assesses surface cleaning practices using UV marker technology and the extent to which this technology can help improve cleaning audits and practices. METHODS: 144 audits (1,235 surfaces) were retrieved. UV marker cleaning audits conducted at a major teaching hospital in 2018 after implementing a new cleaning protocol. In addition, semi-structured interviews were conducted with cleaning staff and supervisors. RESULTS: On average, 63% of surfaces were appropriately cleaned. Toilet handles (80%) and toilet seats underside (83%) scored highest while main room sink fixtures (54%), light switch (55%) and bedrails (56%) scored lowest. Training, staffing and time constraints may play a role in low cleaning rates. DISCUSSION: The high-touch patient surfaces in the bedroom remain neglected and a potential source of infections. UV marker audits provided an objective measure of cleaning practices that managers and staff were unaware of. CONCLUSION: UV markers audits can play a key role in revealing deficiencies in cleaning practices and help in raising awareness of these deficiencies and improving cleaning practices.


id: cord-313409-3n4vyszl
title: Self-reported Impact of Respirator Use on Healthcare Worker Ability to Perform Patient Care
author: Hines, Stella E.
date: 2020-06-11
txt: ./txt/cord-313409-3n4vyszl.txt
cache: ./cache/cord-313409-3n4vyszl.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32534121/
doi: 10.1016/j.ajic.2020.06.005
summary:
  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.

abstract:
  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. A patient's fear reaction variably influenced self-reported healthcare worker compliance with respirator use. Strategies to improve protective equipment design may remove potential barriers to respirator use and allow better healthcare worker-patient relationships.


id: cord-314206-caxz025z
title: Reusable elastomeric air-purifying respirators: Physiologic impact on health care workers
author: Roberge, Raymond J.
date: 2010-03-01
txt: ./txt/cord-314206-caxz025z.txt
cache: ./cache/cord-314206-caxz025z.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/20189685/
doi: 10.1016/j.ajic.2009.11.006
summary:
  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) .

abstract:
  BACKGROUND: Elastomeric air-purifying respirators offer the benefit of reusability, but their physiological impact on health care workers is unknown. METHODS: Ten health care workers exercised at 2 health care-associated work rates wearing an elastomeric air-purifying respirator. Mixed inhalation/exhalation respirator dead space gases (oxygen, carbon dioxide) were sampled, and physiological parameters were monitored (heart rate, breathing rate, tidal volume, minute volume, oxygen saturation, transcutaneous carbon dioxide). Numerical rating scales were used to evaluate comfort and exertion. RESULTS: Compared with controls (no respirator), significant decreases in the breathing rate at both work rates (P < .05) and increases in tidal volume at the lower work rate (P < .01) were noted with respirator use. Approximately half the subjects had transcutaneous carbon dioxide levels above the upper limit of normal after 1 hour of use. Although well tolerated, comfort was negatively impacted by elastomeric air-purifying respirators wear. CONCLUSION: Reusable elastomeric air-purifying respirators impose little additional physiological burden over the course of 1 hour at usual health care work rates. However, the potential for carbon dioxide retention in a significant proportion of users exists and requires further investigation.


id: cord-316442-xwopn97m
author: Lam, Simon Ching
date: 2020-05-13
txt: ./txt/cord-316442-xwopn97m.txt
cache: ./cache/cord-316442-xwopn97m.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0196655320302832?v=s5
doi: 10.1016/j.ajic.2020.05.008
abstract: nan
summary:
  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.

title:
  Global risk to the community and clinical setting: Flocking of fake masks and protective gears during the COVID-19 pandemic


id: cord-317138-6nonzjbq
author: Takagi, Hisato
date: 2020-06-20
txt: ./txt/cord-317138-6nonzjbq.txt
cache: ./cache/cord-317138-6nonzjbq.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.ajic.2020.06.181
doi: 10.1016/j.ajic.2020.06.181
abstract: nan
summary:
  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.

title:
  The higher temperature and ultraviolet, the lower COVID-19 prevalence – Meta-regression of data from large U.S. cities


id: cord-319833-u9uuuu38
author: Rodriguez-Martinez, Carlos E.
date: 2020-07-08
txt: ./txt/cord-319833-u9uuuu38.txt
cache: ./cache/cord-319833-u9uuuu38.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.ajic.2020.07.004
doi: 10.1016/j.ajic.2020.07.004
summary:
  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).

title:
  Decontamination and reuse of N95 filtering facemask respirators: a systematic review of the literature

abstract:
  INTRODUCTION: As has happened in other emerging respiratory pandemics, demand for N95 filtering facemask respirators (FFRs) has far exceeded their manufacturing production and availability in the context of the SARS-CoV-2 pandemic. One of the proposed strategies for mitigating the massive demand for N95 FFRs is their reuse after a process of decontamination that allows the inactivation of any potentially infectious material on their surfaces. This article aims to summarize all of the available evidence on the different decontamination methods that might allow disposable N95 FFRs to be reused, with emphasis on decontamination from SARS-CoV-2. 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. RESULTS: We identified a total of 14 studies reporting on the different decontamination methods that might allow disposable N95 FFRs to be reused, including small-scale energetic methods and disinfecting solutions/spray/wipes. Among these decontamination methods, ultraviolet germicidal irradiation (UVGI) and vaporized hydrogen peroxide (VHP) seem to be the most promising decontamination methods for N95 FFRs, based on their biocidal efficacy, filtration performance, fitting characteristics, and residual chemical toxicity, as well as other practical aspects such as the equipment required for their implementation and the maximum number of decontamination cycles. CONCLUSIONS: Although all the methods for the decontamination and reuse of N95 FFRs have advantages and disadvantages, UVGI and VHP seem to be the most promising methods.


id: cord-322923-zxraxgl1
author: Bayersdorfer, Jennifer
date: 2020-07-16
txt: ./txt/cord-322923-zxraxgl1.txt
cache: ./cache/cord-322923-zxraxgl1.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0196655320307045?v=s5
doi: 10.1016/j.ajic.2020.07.019
summary:
  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.

title:
  Novel Manufacturing of Simple Masks in Response to International Shortages: Bacterial and Particulate Filtration Efficiency Testing

abstract:
  Many healthcare systems have been forced to outsource simple mask production due to international shortages caused by the COVID-19 pandemic. Providence created simple masks using surgical wrap and submitted samples to an environmental lab for bacterial filtration efficiency testing. Bacterial filtration efficiency (BFE) rates ranged from 83.0 – 98.1% depending on specific material and ply, and particular filtration efficiency (PFE) rates ranged from 92.3-97.7%. Based on mask configuration, specific surgical wrap selected, and ply, the recommended filtration efficiency for isolation and surgical masks of 95% and 98%, respectively can be achieved. These alternative masks can allow for similar coverage and safety when hospital-grade isolation masks are in short supply.


id: cord-325598-gy809ee0
author: Lyne, Cloutier
date: 2020-08-21
txt: ./txt/cord-325598-gy809ee0.txt
cache: ./cache/cord-325598-gy809ee0.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0196655320307811
doi: 10.1016/j.ajic.2020.08.015
summary:
  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.

title:
  Asymptomatic carriers of COVID-19 in a confined adult community population in Quebec: a cross-sectional study

abstract:
  Several countries have undertaken social distancing measures to stop SARS-CoV-2’ spread. Asymptomatic carriers’ prevalence is unknown and would provide essential information on hidden viral circulation. 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.


id: cord-326887-lyewg2c9
author: Bloomfield, Sally F.
date: 2007-12-10
txt: ./txt/cord-326887-lyewg2c9.txt
cache: ./cache/cord-326887-lyewg2c9.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0196655307005950
doi: 10.1016/j.ajic.2007.07.001
summary:
  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.

title:
  The effectiveness of hand hygiene procedures in reducing the risks of infections in home and community settings including handwashing and alcohol-based hand sanitizers

abstract:
  Infectious diseases (ID) circulating in the home and community remain a significant concern. Several demographic, environmental, and health care trends, as reviewed in this report, are combining to make it likely that the threat of ID will increase in coming years. Two factors are largely responsible for this trend: first, the constantly changing nature and range of pathogens to which we are exposed and, secondly, the demographic changes occurring in the community, which affect our resistance to infection. This report reviews the evidence base related to the impact of hand hygiene in reducing transmission of ID in the home and community. The report focuses on developed countries, most particularly North America and Europe. It also evaluates the use of alcohol-based hygiene procedures as an alternative to, or in conjunction with, handwashing. The report compiles data from intervention studies and considers it alongside risk modeling approaches (both qualitative and quantitative) based on microbiologic data. The main conclusions are as follows: (1) Hand hygiene is a key component of good hygiene practice in the home and community and can produce significant benefits in terms of reducing the incidence of infection, most particularly gastrointestinal infections but also respiratory tract and skin infections. (2) Decontamination of hands can be carried out either by handwashing with soap or by use of waterless hand sanitizers, which reduce contamination on hands by removal or by killing the organisms in situ. The health impact of hand hygiene within a given community can be increased by using products and procedures, either alone or in sequence, that maximize the log reduction of both bacteria and viruses on hands. (3) The impact of hand hygiene in reducing ID risks could be increased by convincing people to apply hand hygiene procedures correctly (eg, wash their hands correctly) and at the correct time. (4) To optimize health benefits, promotion of hand hygiene should be accompanied by hygiene education and should also involve promotion of other aspects of hygiene.


id: cord-328116-jnll9g6g
author: Malhotra, Sanchi
date: 2020-06-05
txt: ./txt/cord-328116-jnll9g6g.txt
cache: ./cache/cord-328116-jnll9g6g.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0196655320303588?v=s5
doi: 10.1016/j.ajic.2020.05.040
summary:
  -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.

title:
  Shining a Light on the Pathogenicity of Health Care Providers'' Mobile Phones: Use of a Novel Ultraviolet-C Wave Disinfection Device

abstract:
  BACKGROUND: Mobile phones are known to carry pathogenic bacteria and viruses on their surfaces, posing a risk to healthcare providers (HCPs) and hospital infection prevention efforts. We utilize an Ultraviolet-C (UV-C) device to provide an effective method for mobile phone disinfection and survey HCPs about infection risk. METHODS: Environmental swabs were used to culture HCPs’ personal mobile phone surfaces. Four cultures were obtained per phone: before and after the UV-C device's 30-second disinfecting cycle, at the beginning and end of a 12-hour shift. Surveys were administered to participants pre- and post-study. RESULTS: Total bacterial colony forming units (CFUs) were reduced by 90.5% (p=0.006) after one UV-C disinfection cycle, and by 99.9% (p=0.004) after two cycles. Total pathogenic bacterial CFUs were decreased by 98.2% (p=0.038) after one and >99.99% (p=0.037) after two disinfection cycles. All survey respondents were willing to use the UV-C device daily to weekly, finding it convenient and beneficial. DISCUSSION: This novel UV-C disinfecting device is effective in reducing pathogenic bacteria on mobile phones. HCPs would frequently use a phone disinfecting device to reduce infection risk. CONCLUSIONS: In light of the ongoing coronavirus (COVID-19) pandemic, a standardized approach to phone disinfection may be valuable in preventing healthcare-associated infections.


id: cord-330463-j4cf7vzs
title: Indoor air as a vehicle for human pathogens: Introduction, objectives, and expectation of outcome
author: Sattar, Syed A.
date: 2016-09-02
txt: ./txt/cord-330463-j4cf7vzs.txt
cache: ./cache/cord-330463-j4cf7vzs.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0196655316305387
doi: 10.1016/j.ajic.2016.06.010
summary:
  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.

abstract:
  Airborne spread of pathogens can be rapid, widespread, and difficult to prevent. 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. After the presentations, the panel will address a set of preformulated questions on selection criteria for surrogate microbes to study the survival and inactivation of airborne human pathogens, desirable features of technologies for microbial decontamination of indoor air, knowledge gaps, and research needs. It is anticipated that the deliberations of the workshop will provide the attendees with an update on the significance of indoor air as a vehicle for transmitting human pathogens with a brief on what is currently being done to mitigate the risks from airborne infectious agents.


id: cord-330666-puhijixa
author: Carrico, Ruth M.
date: 2007-02-02
txt: ./txt/cord-330666-puhijixa.txt
cache: ./cache/cord-330666-puhijixa.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/17276786/
doi: 10.1016/j.ajic.2005.12.013
summary:
  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.

title:
  Changing health care worker behavior in relation to respiratory disease transmission with a novel training approach that uses biosimulation

abstract:
  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. METHODS: Participants included 20 emergency department registered nurses randomized into 2 groups: control and intervention. The intervention group received supplemental training using the visual demonstration of respiratory particle dispersion. Both groups were then observed throughout their work shifts as they provided care during January-March 2005. RESULTS: Participants who received supplemental visual training correctly utilized personal protective equipment statistically more often than did participants who received only the standard classroom training. 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.


id: cord-331848-tysxrc4o
author: Lammers, Daniel T
date: 2020-07-15
txt: ./txt/cord-331848-tysxrc4o.txt
cache: ./cache/cord-331848-tysxrc4o.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/32682016/
doi: 10.1016/j.ajic.2020.07.021
summary:
  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.

title:
  Safety Code Blue! Assessing the use of blue surgical sterilization wrap for homemade respirator masks during the COVID-19 crisis.

abstract:
  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. This study sought to assess these claims using standardized filter testing. 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.


id: cord-332243-6uc4ricy
author: Lai, Joanna Y.F.
date: 2010-09-25
txt: ./txt/cord-332243-6uc4ricy.txt
cache: ./cache/cord-332243-6uc4ricy.txt
extension: .txt
mime: text/plain
url: https://www.ncbi.nlm.nih.gov/pubmed/20869790/
doi: 10.1016/j.ajic.2010.06.007
summary:
  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.

title:
  Comparison of hand contamination rates and environmental contamination levels between two different glove removal methods and distances

abstract:
  BACKGROUND: Gloves are a necessary contact precaution to prevent transmission of infectious pathogens that spread by direct or indirect contact with an infected person or a contaminated environment. 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. METHODS: Fifty HCWs performed a personal or causal glove removal method (pretest) and a Centers for Disease Control (CDC)-recommended glove removal method (posttest) at distances of 2 feet and 3 feet from the rubbish bin after the application of fluorescent solution (the simulated contaminant) onto their gloved hands. RESULTS: The incidence of the small patch of fluorescent stain (<1 cm(2)) on the front of the doffed gloves was significantly lower in the posttest than in the pretest. The incidence of small and large patches (>1 cm(2)) on the front of the doffed gloves and on the cover of the rubbish bin was significantly lower at 3 feet than at 2 feet. Health care assistants had significantly higher levels of contamination than other HCWs in the pretest but not in the posttest. There was no significant difference in hand contamination rate between pretest and posttest based on distance from the rubbish bin and type of HCW. CONCLUSION: The impact of the glove removal procedure and the distance to the bin in which used gloves are discarded should be taken into consideration on a daily basis, along with the supervision of infection control measures by minor staff.


id: cord-332815-1w1ikj7q
title: Lesson Learned from China Regarding Use of Personal Protective Equipment
author: Zhan, Mingkun
date: 2020-08-11
txt: ./txt/cord-332815-1w1ikj7q.txt
cache: ./cache/cord-332815-1w1ikj7q.txt
extension: .txt
mime: text/plain
url: https://doi.org/10.1016/j.ajic.2020.08.007
doi: 10.1016/j.ajic.2020.08.007
summary:
  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.

abstract:
  BACKGROUND: In Wuhan, China, in December 2019, the novel coronavirus was detected. The virus causing COVID-19 was related to a coronavirus named severe acute respiratory syndrome coronavirus (SARS-CoV). The virus caused an epidemic in China and was quickly contained in 2003. Although coming from the same family of viruses and sharing certain transmissibility factors, the local health institutions in China had no experience with this new virus, subsequently named SARS-CoV-2. 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. RESULTS: This article describes the PPE and protocol for its safe and effective deployment and the implementation of designated hospital units for COVID-19 patients. To date, only two nurses working in China who contracted SARS-CoV-2 have died from COVID-19 in the early period of the epidemic (February 11 and 14, 2020). CONCLUSION: The lessons learned by health care workers in China are shared in the hope of preventing future occupational exposure.


id: cord-333950-e0hd3iuu
author: Maillard, Jean-Yves
date: 2020-04-18
txt: ./txt/cord-333950-e0hd3iuu.txt
cache: ./cache/cord-333950-e0hd3iuu.txt
extension: .txt
mime: text/plain
url: https://www.sciencedirect.com/science/article/pii/S0196655320302091?v=s5
doi: 10.1016/j.ajic.2020.04.011
summary:
  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.

title:
  Reducing antibiotic prescribing and addressing the global problem of antibiotic resistance by targeted hygiene in the home and everyday life settings: A Position Paper

abstract:
  Antimicrobial resistance (AMR) continues to threaten global health. Although global and national AMR action plans are in place, infection prevention and control is primarily discussed in the context of healthcare facilities with home and everyday life settings barely addressed. As seen with the recent global SARS-CoV-2 pandemic, everyday hygiene measures can play an important role in containing the threat from infectious microorganisms. This position paper has been developed following a meeting of global experts in London, 2019. It presents evidence that home and community settings are important for infection transmission and also the acquisition and spread of AMR. It also demonstrates that the targeted hygiene approach offers a framework for maximizing protection against colonization and infections, thereby reducing antibiotic prescribing and minimizing selection pressure for the development of antibiotic resistance. If combined with the provision of clean water and sanitation, targeted hygiene can reduce the circulation of resistant bacteria in homes and communities, regardless of a country's Human Development Index (overall social and economic development). Achieving a reduction of AMR strains in healthcare settings requires a mirrored reduction in the community. 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.


id: cord-339245-02gr4mfy
title: Utilizing Technology to Enhance Screening for Highly Infectious Diseases
author: Ehni, Jordan
date: 2020-07-09
txt: ./txt/cord-339245-02gr4mfy.txt
cache: ./cache/cord-339245-02gr4mfy.txt
extension: .txt
mime: text/plain
url: https://api.elsevier.com/content/article/pii/S0196655320306945
doi: 10.1016/j.ajic.2020.07.008
summary:
  • 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.

abstract:
  • 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. This study focused on the creation of a digital screening tool using a free and publicly available digital survey application to screen patients during a measles outbreak in New York City. The results indicate that digital tools are an effective alternative to paper tools due to their ease of use and remote compliance monitoring capabilities.


id: cord-339362-crtlkju1
title: The electronic medical record and COVID-19: is it up to the challenge?
author: Pryor, Rachel
date: 2020-05-12
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url: https://doi.org/10.1016/j.ajic.2020.05.002
doi: 10.1016/j.ajic.2020.05.002
summary:
  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.

abstract:
  • Improvements to the electronic medical records must occur prior to the next pandemic; • During pandemics, infection preventionists’ should advise staff, not review charts; • Automation can help improve healthcare safety and quality;


id: cord-340051-r9kn34wd
author: MEI, Xue
date: 2020-07-06
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url: https://api.elsevier.com/content/article/pii/S0196655320306465
doi: 10.1016/j.ajic.2020.06.221
summary:
  (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.

title:
  Observations about Symptomatic and Asymptomatic infections of 494 patients with COVID-19 in Shanghai,China

abstract:
  BACKGROUND: Humans are generally susceptible to SARS-CoV-2, which has caused a global pandemic of COVID-19. The screening of infected people in the population still mainly depends on clinical symptoms. However, there is limited research on the characteristics of clinical symptoms in different populations, especially in imported cases. METHODS: To retrospectively analyze the clinical data of 494 confirmed COVID-19 patients admitted to a designated hospital in Shanghai from January 20, 2020, to March 31, 2020, we compared the clinical manifestations in different populations and their influencing factors in COVID-19 patients. RESULTS: (1) Of the 494 patients, 453 (91.7%) had different symptoms at admission, and 39 (7.89%) patients were asymptomatic. (2) We compared the symptoms of patients according to different stratifications and found the following results: a. The proportion of dyspnea was significantly higher in male patients than in female patients (P < 0.05). b. The proportions of a stuffy nose, sore throat, and olfactory and gustatory dysfunction were significantly higher in children than in adult patients (P < 0.05). c. The proportions of fever, chest tightness, shortness of breath, and fatigue were significantly higher in local cases than in imported cases. In comparison, the proportions of nasal congestion, stuffy nose, sore throat, headache, and olfactory and gustatory dysfunction were significantly lower in imported cases than in imported cases (P < 0.05). d. The proportions of chest tightness, shortness of breath, and dyspnea were significantly higher in severely ill patients than in those with mild symptoms (P < 0.05). (3) Thirty-one asymptomatic patients were significantly younger than symptomatic patients, and they had a higher proportion of imported cases, white blood cell (WBC) and lymphocyte (LYM) count levels, and fewer abnormal CT cases than the group of symptomatic patients (P < 0.05). (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). CONCLUSION: The majority of COVID-19 patients (91.7%) had early symptoms. whereas 7.89% of COVID-19 patients were asymptomatic. Younger patients had fewer symptoms, mainly the upper respiratory symptoms, and the illness condition was milder, which was more common in imported cases. Elderly male patients had severe symptoms when admitted. The number of days needed for the patient's symptoms to disappear was closely related to the number of days necessary for the pharyngeal swab nucleic acid test to turn negative.


id: cord-342523-52t7dh4n
title: Direct COVID-19 Infection of Enterocytes: The Role of Hypochlorhydria
author: Dibner, Julia J.
date: 2020-08-11
txt: ./txt/cord-342523-52t7dh4n.txt
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url: https://api.elsevier.com/content/article/pii/S0196655320307689
doi: 10.1016/j.ajic.2020.08.002
summary:
  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) .

abstract:
  COVD-19 disease is characteristically respiratory in nature; however, some patients have gastrointestinal symptoms. These include changes in taste, nausea/vomiting, abdominal pain, and diarrhea. A report has been published of a young patient who repeatedly tested positive in stool samples while nasopharyngeal tests remained negative. This raises doubts about our understanding of the dynamics of COVID-19 disease. 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.


id: cord-345210-6f8niif5
author: Tadavarthy, Silpa N.
date: 2020-07-19
txt: ./txt/cord-345210-6f8niif5.txt
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url: https://www.sciencedirect.com/science/article/pii/S019665532030691X?v=s5
doi: 10.1016/j.ajic.2020.07.006
summary:
  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.

title:
  Developing and Implementing an Infection Prevention and Control Program for a COVID-19 Alternative Care Site in Philadelphia, PA

abstract:
  BACKGROUND: On March 27, 2020, the city of Philadelphia was given permission by Temple University to convert the Liacouras Center gymnasium to an alternate care site (ACS) to treat low-acuity COVID-19 patients. ACS's, especially those created to specifically care for infectious patients, require a robust infection prevention and control (IPC) program. METHODS: The IPC program was led by a physician and nurse partnership, both of whom had substantial experience developing IPC programs in U.S. and low-resource settings. The IPC program was framed on a previously described conceptual model commonly referred to as the “4S's”: Space, Staff, Stuff, and Systems. RESULTS: The gymnasium was transformed into red, yellow and green infection hazard zones. The IPC team trained 425 staff in critical IPC practices and personal protective equipment (PPE) standards. Systems to detect staff illness were created and over 3550 staff health screening surveys completed. DISCUSSION: Use of existing guidance and comprehensive facility and patient management assessments guided the development of the IPC program. Program priorities were to keep staff and patients safe and implement procedures to judiciously use limited resources that affect infection transmission. CONCLUSION: Planning, executing and evaluating IPC standards and requirements of an ACS during a pandemic requires creative and nimble strategies to adapt, substitute, conserve, reuse, and reallocate IPC space, staff, stuff and systems.


id: cord-351031-e8suoeim
author: Liang En Ian, Wee
date: 2020-06-26
txt: ./txt/cord-351031-e8suoeim.txt
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url: https://api.elsevier.com/content/article/pii/S0196655320305691
doi: 10.1016/j.ajic.2020.06.188
summary:
  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.

title:
  Containing COVID-19 outside the isolation ward: the impact of an infection control bundle on environmental contamination and transmission in a cohorted general ward

abstract:
  BACKGROUND: During an ongoing outbreak of COVID-19, unsuspected cases may be housed outside of dedicated isolation wards. AIM: At a Singaporean tertiary hospital, individuals with clinical syndromes compatible with COVID-19 but no epidemiologic risk were placed in cohorted general wards for COVID-19 testing. To mitigate risk, an infection control bundle was implemented comprising infrastructural enhancements, improved personal-protective-equipment (PPE), and social distancing. We assessed the impact on environmental contamination and transmission. METHOD: Upon detection of a case of COVID-19 in the dedicated general ward, patients and healthcare workers (HCWs) contacts were identified. All patient and staff-close contacts were placed on 14-day phone surveillance and followed-up for 28 days; symptomatic contacts were tested. Environmental samples were also obtained. FINDINGS: Over a 3-month period, 28 unsuspected cases of COVID-19 were contained in the dedicated general ward. In 5 of the 28 cases, sampling of the patient's environment yielded SARS-CoV-2; index cases who required supplemental oxygen had higher odds of environmental contamination (p=0.01). A total of 253 staff close-contacts and 45 patient close-contacts were identified; only 3 HCWs (1.2%, 3/253) required quarantine. On 28-day follow-up, no patient-to-HCW transmission was documented; only one symptomatic patient close-contact tested positive. CONCLUSION: Our institution successfully implemented an intervention bundle to mitigate COVID-19 transmission in a multi-bedded cohorted general ward setting.


