Background The Global Trigger Tool (GTT) has become a worldwide used method for estimating adverse events through a retrospective patient record review. However, little is known about the facilitators and the challenges in the GTT-implementation process. Thus, this study followed two aims: First, to apply a comprehensive set of feasibility criteria to qualitatively and systematically assess the GTT-implementation process in three departments of German university hospitals. Second, to identify the facilitators and the obstacles met in the GTT-implementation process and to derive recommendations for supporting other hospitals in implementing the GTT in clinical practice. Methods The study used a qualitative documentary method based on process documentation, with written and verbal feedback from the reviewer, as well as evaluating the study sites during the implementation process. The study was conducted in three departments, each in a different German university hospital. The authors applied a comprehensive set of 22 feasibility criteria assessing the level of challenge in GTT implementation. The results were synthesized and they focused on the facilitators and the challenges. Results Of these 22 feasibility criteria, nine were assessed as a low-level challenge, eleven regarded as a moderate-level challenge, and two with a problematic level of challenge. In particular, the lack of time and staff resources, the quality of the information in the patient records, organizational procedures, and local issues, posed major challenges in the implementation process. By contrast, the use of local coordinators and an external expert made important contributions to the GTT implementation. Conclusions Considering the facilitators and the obstacles beforehand may help with the implementation of the GTT in routine practice. In particular, early and effective planning can reduce or prevent critical challenges in terms of time, staff resources, and organizational aspects.
Objective: To evaluate the frequency, duration and patterns of long-term coronavirus disease 2019 (COVID-19) symptoms and to analyze risk factors for long-lasting COVID-19 sequelae among hospital employees (HEs). Design: Retrospective observational cohort study. Setting: Three medical centers in Cologne, Germany. Participants: We included HEs who had a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction (PCR) test between March 2020 and May 2021. Methods: We conducted a survey in mid-2021 with all HEs tested SARS-CoV-2 PCR positive during the study period and asked about the presence and duration of 24 different COVID-19 related symptoms. Chronological development and patterns of symptom complexes, probability of symptom persistence and possible risk factors for protracted COVID-19 course were analyzed. Results: Of 221 included HEs, a number of 104 HEs (47.1%) reported at least one persisting symptom for more than 90 days after initial SARS-CoV-2 detection. A symptom duration over 28 days was associated with multiple symptom complexes. The most common was the interrelated occurrence of shortness of breath, memory disorder, concentration disorders and fatigue. Each one cycle higher initial Ct value significantly increased the chances of overcoming symptoms (odds ratio [OR] = 1.05; p = 0.019). The occurrence of breathlessness within the first ten days (OR = 7.89; p = 0.008), an initial Ct value under 30 (OR = 3.36; p = 0.022) and a definitely nosocomial SARS-CoV-2 transmission (OR = 3.05; p = 0.049) showed a statistically significant association with increased odds of illness duration over 90 days. Conclusion: About half of the HEs suffered from long lasting symptoms over 90 days after almost entirely mild acute COVID-19. Different symptom complexes could be shown and predictive factors for long-term symptoms were identified. Predictive factors at the onset of the infection could possibly be used for early treatment to prevent development of long-term symptoms after COVID-19 in future.
Purpose To evaluate the frequency, duration and patterns of long-term coronavirus disease 2019 (COVID-19) symptoms and to analyse risk factors for long-lasting COVID-19 sequelae among a cohort of hospital employees (HEs).Methods We conducted a survey regarding persistent COVID-19 related symptoms with all HEs from three medical centres in Cologne, Germany, who were tested SARS-CoV-2 PCR positive from March 2020 until May 2021. Duration of symptoms and possible risk factors for protracted COVID-19 course were analysed.Results Of 221 included HEs, a number of 104 HEs (47.1%) reported at least one persisting symptom for more than 90 days after initial SARS-CoV-2 detection. Each one cycle higher initial Ct value significantly increased the chances of overcoming symptoms (odds ratio [OR] = 1.05; p = 0.019). The occurrence of breathlessness within the first ten days (OR = 7.89; p = 0.008), an initial Ct value under 30 (OR = 3.36; p = 0.022) and a definitely nosocomial SARS-CoV-2 transmission (OR = 3.05; p = 0.049) showed a statistically significant association with increased odds of illness duration over 90 days.Conclusion About half of the HEs suffered from long lasting symptoms over 90 days after almost entirely mild acute COVID-19. Predictive factors could possibly be used for early treatment to prevent development of long-term symptoms after COVID-19 in future.
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