Infection Disease & Health最新文献

Background

Health literacy is key to navigating the current global epidemic of misinformation and inaccuracy relating to healthcare. The American Medical Association (AMA) suggests health information should be written at the level of American sixth grade. With the monkeypox outbreak being declared a Public Health Emergency of International Concern (PHEIC) in July 2022, we sought to assess the readability of online patient education materials (PEMs) relating to monkeypox to see if they are at the target level of readability.

Methods

A search was conducted on Google.com using the search term ‘Monkeypox’. The top 50 English language webpages with patient education materials (PEMs) relating to monkeypox were compiled and categorised by country of publication and URL domain. Readability was assessed using five readability tools: Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL), Gunning Fog Index (GFI), Coleman-Liau Index (CLI), and, Simple Measure of Gobbledygook Index (SMOG). Unpaired t-test for URL domain, and one-way ANOVA for country were performed to determine influence on readability.

Results

Three of the five tools (FRES, GFI, CLI) identified no webpages that met the target readability score. The FKGL and SMOG tools identified one (2%) and two (4%) webpages respectively that met the target level. County and URL domain demonstrated no influence on readability.

Conclusion

Online PEMs relating to monkeypox are written above the recommended reading level. Based on the previously established effect of health literacy, this is likely exacerbating health inequalities. This study highlights the need for readability to be considered when publishing online PEMs.

Background

Infection prevention and control (IPC) in the medical imaging (MI) setting is recognised as an important factor in providing high-quality patient care and safe working conditions. Surveys are commonly used and have advantages for IPC research. The aim of this study was to identify the core concepts in surveys published in the literature that examined IPC in MI environments.

Methods

A literature review was conducted to identify studies that employed a survey relating to IPC in the MI setting. For each included study, descriptive study information and survey information were extracted. For IPC-specific survey items, directed content analysis was undertaken, using eleven pre-determined codes based on the ‘Australian Guidelines for the Prevention and Control of Infection in Healthcare'. Content that related to ‘Knowledge', ‘Attitudes' and ‘Practice' were also identified.

Results

A total of 23 studies and 21 unique surveys were included in this review. IPC-specific survey items assessed diverse dimensions of IPC, most commonly relating to ‘transmission-based precautions' and ‘applying standard and transmission-based precautions during procedures'. ‘Practice' and ‘Knowledge' related survey items were most frequent, compared to ‘Attitudes'.

Conclusion

MI research using survey methods have focused on the ‘entry' points of IPC, rather than systemic IPC matters around policy, education, and stewardship. The concepts of ‘Knowledge', ‘Attitudes' and ‘Practice' are integrated in IPC surveys in the MI context, with a greater focus evident on staff knowledge and practice. Existing topics within IPC surveys in MI are tailored to individual studies and locales, with lack of consistency to national frameworks.

In the 1980s Contact Precautions were introduced as a precautionary measure to control the emerging threat of antimicrobial resistance in hospitals, particularly methicillin resistant Staphylococcus aureus (MRSA). Today, antimicrobial resistance remains a concerning global public health threat, and a focus for hospital patient safety priorities.

In late 2019 a novel respiratory virus described as SARS-CoV-2, was reported. Just as MRSA had prompted control measures developed in the context of limited information and understanding of the pathogen, public health control measures against SARS-CoV-2 were promptly and strictly implemented.

Whilst SARS-CoV-2 control measures were successful at containing the virus, numerous detrimental socio-economic and health impacts have led to a rebalancing of harms versus benefits and loosening of restrictions. Conversely, evidence collated over the past 50 years, suggests that Contact Precautions are not superior to well-applied standard infection prevention and control precautions in controlling MRSA acquisition in hospitals. Several harms associated with Contact Precautions, affecting patient safety, financial costs, and organisational culture, are described. However, rebalancing of hospital MRSA control policies has been slow to materialise.

This commentary invites infection prevention and control policy makers to reflect and revise policies for the control of MRSA in hospitals so that harms do not outweigh benefits.

Background

To describe and analyse the infection prevention and control (IPC) curricula within Public Health degrees across Australian and New Zealand Universities and identify foundational IPC knowledge deficits.

Methods

A cross-sectional study of public health and related programs across tertiary education institutions within Australia and New Zealand was conducted to comprehensively illustrate the current inclusion of IPC core and elective courses and identify areas of IPC content deficit.

Results

Australian (n = 32) and New Zealand (n = 9) universities were audited, consisting of 217 public health/public health related degrees within Australia and 45 within New Zealand. Within Australia 41% of public health degrees and 49% in New Zealand did not offer any IPC content as core or elective subjects.

Conclusions

Public health tertiary education in Australia and New Zealand is lacking in equipping and imbedding IPC skills and knowledge in public health graduates. This highlights the need for a framework guiding mandatory IPC content within Australian and New Zealand public health programs.

Background

Respiratory hygiene, especially in context of COVID-19, is of upmost importance. Healthcare professionals (HCPs) play an important role in the prevention of infections. Their perceptions of the subject are needed to tailor effective communication and training on prevention.

Methods

20 French HCPs were questioned about their perceptions on respiratory hygiene and infections, by the means of recorded semi-structured interviews and a focus group. The interviews and focus group were transcribed then analysed through lexicometric and thematic content analyses.

Results

HCP discourse revolved around the use of face masks, the prevention and the characteristics of respiratory infections and the means to prevent them.COVID-19 excepted, HCPs considered respiratory infections as benign. They associated respiratory hygiene to the observance of cough etiquette, the preservation of lung health, the act of protecting oneself and others, and the adherence to safety protocols. Main barriers to good practices were organizational ones, such as the lack of consultation and mobilization of HCPs in the development of preventive measures, suboptimal information sharing and the physical and relational constraints of face masks. They advised means of improving communication and information promotion.

Conclusion

Since the pandemic crisis, HCPs have developed a better awareness about the prevention of respiratory infections. Except for COVID-19, respiratory infections are mostly considered as benign. Barriers and facilitators evoked by HCPs will help to build national communication and tools.

Background

Health care professionals (HCP) were obliged to wear personal protective equipment (PPE) during pandemic in order to minimize the risk of transmission of the emerging virus. The objective of the study was to estimate the prevalence of adverse effects related to the wear of PPE among HCP and to determinate their predictive factors.

Methods

This was a cross-sectional study including a representative sample of 300 randomized HCP at Hedi Chaker University Hospital Sfax, Tunisia, during the period August-September 2021. Data collection was carried out by an anonymous self-administered questionnaire.

Results

PPE related adverse effects were noted among 87 HCP with a prevalence of 57.2%. Multivariate analysis showed that factors independently associated with PPE adverse effects were female gender (Adjusted Odds Ratio (AOR) = 1.8; p = 0.048), chronic diseases (AOR = 0.29; p = 0.001) and previous infection with COVID-19 (AOR = 0.46; p = 0.004). Frequent use of bleach or other disinfection product without protection and use of hot water at work were independently associated with a high risk of adverse effects ((AOR = 2.22; p = 0.003) and (AOR = 2.83; p = 0.005), respectively). Similarly, a duration of use of PPE>4 h per day (AOR = 1.98; p = 0.039), as well as use of visors and/or glasses (AOR = 1.84; p = 0.045) were independently associated with PPE related adverse effects.

Conclusion

The prevalence of adverse effects related to the wear of PPE was alarmingly high among HCP. Multiple risk factors were highlighted, notably professional aspects. Adequate and repetitive training for caregivers on the correct use of PPE remain essential to manage this problem.

Background

Despite the large number of hospitalized patients affected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, few data are available about risk factors and mortality in subjects with nosocomially acquired respiratory infection of Coronavirus Disease 2019 (COVID-19).

Methods

We retrospectively evaluated in a multicentric study -during the pre-vaccination era-all patients admitted with confirmed diagnosis of nosocomial COVID-19 (NC). Patients were classified according to provenance: hospital-acquired NC or long-term care (LTC) facilities.

Results

Among overall 1047 patients evaluated with COVID-19, 137 had a confirmed diagnosis of NC (13%). 78 (56.9%) patients had hospital-acquired NC and 59 (43%) had LTC NC. Overall mortality was 35.8%, in hospital-acquired NC 24.4%, in LTC NC 50.8% (p < 0.001) (Log Rank test: p = 0.001). Timing of diagnosis was significantly different between hospital acquired and LTC NC (3.5 vs 10 days, p < 0.001). In multivariate analysis age, intensive-care unit admission, LTC provenance and sepsis were significant predictors of mortality in patients with NC infection.

Conclusion

Patients with NC are at higher risk of mortality (especially for LTC NC) and required preventive strategies, early diagnosis, and treatment to avoid COVID-19 cluster.