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Scabies outbreak among healthcare workers in a German acute care hospital.

ABSTRACT: This article reports on a scabies outbreak among healthcare workers (HCW) in an acute care hospital. The outbreak was associated with a patient suffering from a chronic skin disease that was later diagnosed as crusted scabies.The objective was to determine the outbreak drivers and define a prevention strategy against future outbreaks.All staff that had contact with the patient were treated with 5% permethrin ointment. An interdisciplinary outbreak investigation team was established. The team conducted a questionnaire-based case-control study.After the permethrin treatment, no further case was found. Twenty-seven HCWs who had contact with the index patient answered the questionnaire (response rate 73%). The outbreak questionnaire revealed 13 cases of secondary scabies among HCWs. In the multivariable analysis, a lack of glove use (odds ratio [OR], 9.8; P value = 0.036) and frequent close physical contact (OR, 8.151; P value = 0.038) were associated with increased risk of scabies acquisition.The scabies outbreak was most likely driven by three factors: an index patient with crusted scabies; a delayed diagnosis of this patient; and close physical contact without gloves during his hospital stay. The use of disposable gloves for patients with unclear dermatological diagnosis have the potential to limit future scabies outbreaks.

SUBMITTER: Leistner R

PROVIDER: S-EPMC5496690 | biostudies-other | 2017 Jul

REPOSITORIES: biostudies-other

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Scabies outbreak among healthcare workers in a German acute care hospital.

Leistner Rasmus R Buchwald Dirk D Beyer Marc M Philipp Sandra S

Journal of infection prevention 20170201 4

<h4>Background</h4>This article reports on a scabies outbreak among healthcare workers (HCW) in an acute care hospital. The outbreak was associated with a patient suffering from a chronic skin disease that was later diagnosed as crusted scabies.<h4>Objective</h4>The objective was to determine the outbreak drivers and define a prevention strategy against future outbreaks.<h4>Methods</h4>All staff that had contact with the patient were treated with 5% permethrin ointment. An interdisciplinary outb ...[more]

PMID: 28989526

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Project description:ObjectivesThis study examines perceptions of the operational and organisational management of a major outbreak of Middle East Respiratory Syndrome (MERS) caused by a novel coronavirus (MERS-CoV) in the Kingdom of Saudi Arabia (KSA). Perspectives were sought from key decision-makers and clinical staff about the factors perceived to promote and inhibit effective and rapid control of the outbreak.SettingA large teaching tertiary healthcare centre in KSA; the outbreak lasted 6 weeks from June 2015.ParticipantsData were collected via individual and focus group interviews with 28 key informant participants (9 management decision-makers and 19 frontline healthcare workers).DesignWe used qualitative methods of process evaluation to examine perceptions of the outbreak and the factors contributing to, or detracting from successful management. Data were analysed using qualitative thematic content analysis.ResultsFive themes and 15 subthemes were found. The themes were related to: (1) the high stress of the outbreak, (2) factors perceived to contribute to outbreak occurrence, (3) factors perceived to contribute to success of outbreak control, (4) factors inhibiting outbreak control and (5) long-term institutional gains in response to the outbreak management.ConclusionManagement of the MERS-CoV outbreak at King Abdulaziz Medical City-Riyadh was widely recognised by staff as a serious outbreak of local and national significance. While the outbreak was controlled successfully in 6 weeks, progress in management was inhibited by a lack of institutional readiness to implement infection control (IC) measures and reduce patient flow, low staff morale and high anxiety. Effective management was promoted by greater involvement of all staff in sharing learning and knowledge of the outbreak, developing trust and teamwork and harnessing collective leadership. Future major IC crises could be improved via measures to strengthen these areas, better coordination of media management and proactive staff counselling and support.

Project description:At the start of the SARS-CoV-2 pandemic, healthcare workers had an increased risk of acquiring coronavirus disease (COVID)-19. As tertiary care hospitals are critical for the treatment of severely ill patients, the University Hospital Erlangen offered BNT162b2 mRNA vaccination against COVID-19 to all employees when the vaccine became available in Germany. Here, we performed a survey to assess the age- and sex-dependent reactogenicity and safety of BNT162b2 in a real-life setting with a special emphasis on the rate of vaccine-related incapacity to work amongst the employees. All vaccinated employees were invited to participate in the survey and received access to an electronic questionnaire between 31 March and 14 June 2021, which allowed them to report local and systemic adverse effects after the first or second vaccine dose. A total of 2372 employees completed the survey. After both the first and second dose, women had a higher risk than men for vaccine-related systemic side effects (odds ratio (OR) 1.48 (1.24-1.77) and 1.49 (1.23-1.81), respectively) and for inability to work (OR 1.63 (1.14-2.34) and 1.85 (1.52-2.25), respectively). Compared to employees ≥ 56 years of age, younger vaccinated participants had a higher risk of systemic reactions after the first (OR 1.35 (1.07-1.70)) and second vaccination (OR 2.08 (1.64-2.63)) and were more often unable to work after dose 2 (OR 2.20 (1.67-2.88)). We also recorded four anaphylactic reactions and received two reports of severe adverse effects indicative of vaccine complications. After the first and second vaccination, 7.9% and 34.7% of the survey participants, respectively, were temporarily unable to work, which added up to 1700 days of sick leave in this cohort. These real-life data extend previous results on the reactogenicity and safety of BNT162b2. Loss of working time due to vaccine-related adverse effects was substantial, but was outweighed by the potential benefit of prevented cases of COVID-19.

Project description:Background and aimsHealthcare worker burnout has been linked to increased patient safety risk, low work professionalism, and low satisfaction with the care encounter. This study aimed to find the prevalence and factors associated with burnout among healthcare workers in acute care settings at a national referral hospital in Tanzania.MethodsAn analytical cross-sectional study was performed at a national referral hospital in Tanzania. Healthcare workers at the departments of Emergency Medicine, Intensive Care Unit, and Anesthesia at Muhimbili National Hospital were recruited from January 2021 to March 2021. A two-part questionnaire adopted from the Maslach Burnout Inventory (MBI) and MBI-Human Services Survey tool were administered to measure burnout. Categorical variables were summarized using frequencies and percentages, and variables were compared using logistic regression.ResultsA total of 174 healthcare workers were issued questionnaires to participate in the study. With a response rate of 78%, 135 healthcare workers were included in the study, 43.7% were from the intensive care unit; the majority were female (63.7%), and assistant nursing officers (42%). The prevalence of burnout among participants was 62%, with 90.4% of participants showing a high level of emotional exhaustion. A longer duration of a single-day shift was associated with increased burnout among work-related factors (p < 0.001). Fewer night-time sleeping hours, tobacco use, and lack of regular exercise were significantly associated with increased burnout among social-related factors (p < 0.001).ConclusionThe study showed an alarmingly high prevalence of burnout among healthcare workers in the acute care setting of Muhimbili National Hospital. Personal well-being and participation in wellness programs have been associated with a reduced prevalence of burnout. The hospital should address the issue of burnout among its healthcare workers. This also calls for immediate action, necessitating further studies at the regional and national levels to ascertain the burden and causes of burnout in this setting.

Project description:BackgroundAnxiety symptoms (AS) are exacerbated in healthcare workers (HCWs) during the COVID-19 pandemic. Spirituality is known to protect against AS in the general population and it is a construct that differs from religion. It can be assessed using structured questionnaires. A validated questionnaire disclosed three spirituality dimensions: peace, meaning, and faith. In HCWs we investigated the predictors of chronic anxiety (pre-COVID-19 and during the pandemic) and acute anxiety (only during the pandemic), including spirituality in the model. Then, we verified which spirituality dimensions predicted chronic and acute anxiety. Lastly, we studied group differences between the mean scores of these spirituality dimensions.Material and methodsThe study was carried out in a Brazilian Hospital. HCWs (n = 118) were assessed for spirituality at a single time-point. They were also asked about AS that had started pre-COVID-19 and persisted during the pandemic (chronic anxiety), and AS that had started only during the pandemic (acute anxiety). The subjects without chronic anxiety were subdivided into two other groups: acute anxiety and without chronic and acute anxiety. Forward stepwise logistic regressions were used to find the significant AS predictors. First, the model considered sex, age, religious affiliation, and spirituality. Then, the analysis were performed considering only the three spirituality dimensions. Group means differences in the spirituality dimensions were compared using univariate ANCOVAS followed by T-tests.ResultsSpirituality was the most realible predictor of chronic (OR = 0.818; 95%CI:0.752-0.890; p<0.001) and acute anxiety (OR = 0.727; 95%CI:0.601-0.881; p = 0.001). Peace alone predicted chronic anxiety (OR = 0.619; 95%CI:0.516-0.744; p<0.001) while for acute anxiety both peace (OR:0.517; 95%CI:0.340-0.787; p = 0.002), and faith (OR:0.674; 95%CI:0.509-0.892; p = 0.006) significantly contributed to the model. Faith was significantly higher in subjects without AS.ConclusionHigher spirituality protected against chronic and acute anxiety. Faith and peace spirituality dimensions conferred protection against acute anxiety during the pandemic.

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Scabies outbreak among healthcare workers in a German acute care hospital.

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Scabies outbreak among healthcare workers in a German acute care hospital.

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