Background Healthcare workers (HCW) are at increased risk of infection with SARS-CoV-2. Vulnerable patient populations in particular must be protected, and clinics should not become transmission hotspots to avoid delaying medical treatments independent of COVID. Because asymptomatic transmission has been described, routine screening of asymptomatic HCW would potentially be able to interrupt chains of infection through early detection. Methods A systematic search was conducted in the Cochrane COVID-19 Study Register, Web of Science and WHO COVID‐19 Global literature on coronavirus with regard to non-incident related testing of healthcare workers using polymerase chain reaction on May 4th 2021. Studies since January 2020 were included. An assessment of risk of bias and representativeness was performed. Results The search identified 39 studies with heterogeneous designs. Data collection of the included studies took place from January to August 2020. The studies were conducted worldwide and the sample size of the included HCW ranged from 70 to 9449 participants. In total, 1000 of 51,700 (1.9%) asymptomatic HCW were tested positive for SARS-CoV-2 using PCR testing. The proportion of positive test results ranged between 0 and 14.3%. No study reported on HCW-screening related reductions in infected person-days. Discussion and conclusions The heterogeneous proportions might be explained by different regional incidences, lock-downs, and pre-analytical pitfalls that reduce the sensitivity of the nasopharyngeal swab. The very high prevalence in some studies indicates that screening HCW for SARS-CoV-2 may be important particularly in geographical regions and pandemic periods with a high-incidence. With low numbers and an increasing rate of vaccinated HCW, a strict cost–benefit consideration must be made, especially in times of low incidences. Since we found no studies that reported on HCW-screening related reductions in infected person-days, re-evaluation should be done when these are available.
The hospital water environment can be a reservoir for a multiward outbreak, leading to acquisitions or transmissions of multidrug-resistant organisms in a hospital setting. The majority of Gram-negative bacteria are able to build biofilms and persist in the hospital plumbing system over a long period of time.
Background For effective prevention of nosocomial transmissions continuous training and motivation of health care workers (HCW) are essential to maintain and increase compliance with high rates of hand hygiene. The use of Virtual Reality (VR) seems to be a contemporary and interesting approach for hand hygiene training in HCW. Nevertheless, HCW should be asked for their preferences as intrinsic motivation is essential for compliance with hand hygiene and training success should be evaluated. Methods A prospective, cross-controlled trial was conducted at two wards in a tertiary care hospital comparing a conventional lecture for hand hygiene to the use of VR. Both interventions were assigned at ward level. Primary outcome was HCW acceptance, which was verified in a third ward, secondary outcomes were hand rub consumption and compliance to indications for hand hygiene as proposed by WHO. Results In summary, 81 trainings were conducted, 48 VR trainings and 33 trainings by lecture. VR training was well accepted by HCW with a mean score in all items from 3.9 to 4.3 (out of 5). While most HCW (69%) would prefer VR teaching rather than a lecture for hand hygiene education, only 4% preferred the traditional lecture. 400 observations of hand hygiene indications were made, 50 before intervention and 50 after each intervention at the three wards. Mean proportion of correct and indication-appropriate performances was 81% before intervention, 87% after VR training (p = 0.12), and 95% after lecture (p = 0.04). Hand rub consumption did not change significantly in any group. Conclusions Due to the high acceptance of VR technology among healthcare workers, it can be considered an interesting addition to conventional lectures for teaching hand hygiene. However, the hypothesis that VR teaching has a higher impact on hand rub use and hand hygiene compliance than a conventional lecture cannot be confirmed.
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