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Ansgar W Lohse - One of the best experts on this subject based on the ideXlab platform.
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ebola and psychological stress of health care professionals
Emerging Infectious Diseases, 2015Co-Authors: Marco Lehmann, Ansgar W Lohse, Christian A Bruenahl, Bernd Lowe, Marylyn M Addo, Stefan Schmiedel, Christoph SchrammAbstract:To the Editor: Providing medical care for Ebola virus–infected patients entails physical and psychological stress, extended shift times, and risk for infection. In addition, the wearing of personal protective equipment impairs communication and performance of diagnostic and therapeutic procedures. Lessons learned from outbreaks of other infectious diseases indicate that such challenging treatment environments require the monitoring of health care professionals for psychological distress (e.g., anxiety, depression, fatigue, and social Isolation) to prevent personal exhaustion and reduced job performance (1). In August 2014, the first patient in Germany known to have Ebola virus disease was admitted to the University Medical Center Hamburg-Eppendorf (2) and received treatment in the Isolation Facility for 18 days. We hypothesized that health care professionals working in the Isolation unit who had direct contact with the Ebola patient would show more signs of psychological distress than those not working in the Isolation unit. To test our hypothesis, we conducted a cross-sectional controlled study by using validated self-report scales (1,3–5) and open-response questions. Seven days after the Ebola patient was admitted, we distributed questionnaires to the 46 health care professionals (17 physicians, 29 nurses) who had direct contact with the patient (Table). Table Demographic characteristics, self-reported symptoms, and evaluation of working conditions of health care professionals with and without direct contact with an Ebola patient, Germany, 2014* Of the 46 health care professionals, 30 participated in the study. During patient contact, these staff members wore Astro-Protect pressurized suits (Asatex, Bergheim, Germany). As a control group, 40 health care professionals from other wards in the same department were recruited and participated in the study. Providers in the control group cared for terminally ill patients and for patients with reduced consciousness, but they had no direct contact with the Ebola patient. The control participants were not recruited from intensive care units because, at the time of the study, the patient was not receiving intensive care treatment. The 2 groups were balanced with respect to age and occupational characteristics (Table). There was no special psychological support service for health care workers in this hospital. Staff members had received mandatory biweekly training, which included decontamination procedures, technical aspects of diagnostic procedures, and emergency care. In contrast to our hypothesis, no significant differences emerged between the 2 groups with respect to the severity of somatic symptoms, anxiety, depression, and fatigue (Table). Moreover, mean total scores for both groups were at a comparable level to mean scores for the general population (3–5). However, health care professionals who had direct contact with the Ebola patient reported significantly greater social Isolation and felt significantly more need for shorter shift hours. The open responses of participants who experienced social Isolation suggested that their spouses, children, and other relatives had infection-related concerns. Additionally, half of the participants who did not have direct patient contact reported feeling a need for psychological preparation (Table). Nevertheless, almost all health care professionals (97% of those with direct patient contact, 93% of those without direct patient contact) believed that the health care facilities of the hospital were safe. Our investigation of the psychological stress of health care professionals in a Western tertiary care center showed that a well-trained and dedicated team can cope well with the stress of caring for a severely ill Ebola patient. Of note, the direct patient contact group tended to comprise more male participants and more participants living with partners, which may have influenced the experience of psychological stress. No staff member refused to participate in the treatment of the Ebola patient, which underlines the high level of motivation within the team and may render direct comparison to other centers difficult. While the patient was in the Isolation unit, working shifts lasted up to 12 hours, consisting of 2 periods with 3–4 hours of work while wearing personal protective equipment in addition to time spent disinfecting. Most respondents felt that these shifts were too long. We therefore suggest that shift durations should be decreased to 8 hours comprising 2 blocks of 2 hours each for direct patient contact. Shorter shifts should improve staff satisfaction with the working conditions and potentially increase the personal safety of all health care personnel involved in direct patient contact.
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a case of severe ebola virus infection complicated by gram negative septicemia
The New England Journal of Medicine, 2014Co-Authors: Benno Kreuels, Dominic Wichmann, Petra Emmerich, Jonas Schmidtchanasit, Geraldine De Heer, Stefan Kluge, Abdourahmane Sow, Thomas Renne, Stephan Gunther, Ansgar W LohseAbstract:Ebola virus disease (EVD) developed in a patient who contracted the disease in Sierra Leone and was airlifted to an Isolation Facility in Hamburg, Germany, for treatment. During the course of the illness, he had numerous complications, including septicemia, respiratory failure, and encephalopathy. Intensive supportive treatment consisting of high-volume fluid resuscitation (approximately 10 liters per day in the first 72 hours), broad-spectrum antibiotic therapy, and ventilatory support resulted in full recovery without the use of experimental therapies. Discharge was delayed owing to the detection of viral RNA in urine (day 30) and sweat (at the last assessment on day 40) by means of polymerase-chain-reaction (PCR) assay, but the last positive culture was identified in plasma on day 14 and in urine on day 26. This case shows the challenges in the management of EVD and suggests that even severe EVD can be treated effectively with routine intensive care.
Christoph Schramm - One of the best experts on this subject based on the ideXlab platform.
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ebola and psychological stress of health care professionals
Emerging Infectious Diseases, 2015Co-Authors: Marco Lehmann, Ansgar W Lohse, Christian A Bruenahl, Bernd Lowe, Marylyn M Addo, Stefan Schmiedel, Christoph SchrammAbstract:To the Editor: Providing medical care for Ebola virus–infected patients entails physical and psychological stress, extended shift times, and risk for infection. In addition, the wearing of personal protective equipment impairs communication and performance of diagnostic and therapeutic procedures. Lessons learned from outbreaks of other infectious diseases indicate that such challenging treatment environments require the monitoring of health care professionals for psychological distress (e.g., anxiety, depression, fatigue, and social Isolation) to prevent personal exhaustion and reduced job performance (1). In August 2014, the first patient in Germany known to have Ebola virus disease was admitted to the University Medical Center Hamburg-Eppendorf (2) and received treatment in the Isolation Facility for 18 days. We hypothesized that health care professionals working in the Isolation unit who had direct contact with the Ebola patient would show more signs of psychological distress than those not working in the Isolation unit. To test our hypothesis, we conducted a cross-sectional controlled study by using validated self-report scales (1,3–5) and open-response questions. Seven days after the Ebola patient was admitted, we distributed questionnaires to the 46 health care professionals (17 physicians, 29 nurses) who had direct contact with the patient (Table). Table Demographic characteristics, self-reported symptoms, and evaluation of working conditions of health care professionals with and without direct contact with an Ebola patient, Germany, 2014* Of the 46 health care professionals, 30 participated in the study. During patient contact, these staff members wore Astro-Protect pressurized suits (Asatex, Bergheim, Germany). As a control group, 40 health care professionals from other wards in the same department were recruited and participated in the study. Providers in the control group cared for terminally ill patients and for patients with reduced consciousness, but they had no direct contact with the Ebola patient. The control participants were not recruited from intensive care units because, at the time of the study, the patient was not receiving intensive care treatment. The 2 groups were balanced with respect to age and occupational characteristics (Table). There was no special psychological support service for health care workers in this hospital. Staff members had received mandatory biweekly training, which included decontamination procedures, technical aspects of diagnostic procedures, and emergency care. In contrast to our hypothesis, no significant differences emerged between the 2 groups with respect to the severity of somatic symptoms, anxiety, depression, and fatigue (Table). Moreover, mean total scores for both groups were at a comparable level to mean scores for the general population (3–5). However, health care professionals who had direct contact with the Ebola patient reported significantly greater social Isolation and felt significantly more need for shorter shift hours. The open responses of participants who experienced social Isolation suggested that their spouses, children, and other relatives had infection-related concerns. Additionally, half of the participants who did not have direct patient contact reported feeling a need for psychological preparation (Table). Nevertheless, almost all health care professionals (97% of those with direct patient contact, 93% of those without direct patient contact) believed that the health care facilities of the hospital were safe. Our investigation of the psychological stress of health care professionals in a Western tertiary care center showed that a well-trained and dedicated team can cope well with the stress of caring for a severely ill Ebola patient. Of note, the direct patient contact group tended to comprise more male participants and more participants living with partners, which may have influenced the experience of psychological stress. No staff member refused to participate in the treatment of the Ebola patient, which underlines the high level of motivation within the team and may render direct comparison to other centers difficult. While the patient was in the Isolation unit, working shifts lasted up to 12 hours, consisting of 2 periods with 3–4 hours of work while wearing personal protective equipment in addition to time spent disinfecting. Most respondents felt that these shifts were too long. We therefore suggest that shift durations should be decreased to 8 hours comprising 2 blocks of 2 hours each for direct patient contact. Shorter shifts should improve staff satisfaction with the working conditions and potentially increase the personal safety of all health care personnel involved in direct patient contact.
Marco Lehmann - One of the best experts on this subject based on the ideXlab platform.
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ebola and psychological stress of health care professionals
Emerging Infectious Diseases, 2015Co-Authors: Marco Lehmann, Ansgar W Lohse, Christian A Bruenahl, Bernd Lowe, Marylyn M Addo, Stefan Schmiedel, Christoph SchrammAbstract:To the Editor: Providing medical care for Ebola virus–infected patients entails physical and psychological stress, extended shift times, and risk for infection. In addition, the wearing of personal protective equipment impairs communication and performance of diagnostic and therapeutic procedures. Lessons learned from outbreaks of other infectious diseases indicate that such challenging treatment environments require the monitoring of health care professionals for psychological distress (e.g., anxiety, depression, fatigue, and social Isolation) to prevent personal exhaustion and reduced job performance (1). In August 2014, the first patient in Germany known to have Ebola virus disease was admitted to the University Medical Center Hamburg-Eppendorf (2) and received treatment in the Isolation Facility for 18 days. We hypothesized that health care professionals working in the Isolation unit who had direct contact with the Ebola patient would show more signs of psychological distress than those not working in the Isolation unit. To test our hypothesis, we conducted a cross-sectional controlled study by using validated self-report scales (1,3–5) and open-response questions. Seven days after the Ebola patient was admitted, we distributed questionnaires to the 46 health care professionals (17 physicians, 29 nurses) who had direct contact with the patient (Table). Table Demographic characteristics, self-reported symptoms, and evaluation of working conditions of health care professionals with and without direct contact with an Ebola patient, Germany, 2014* Of the 46 health care professionals, 30 participated in the study. During patient contact, these staff members wore Astro-Protect pressurized suits (Asatex, Bergheim, Germany). As a control group, 40 health care professionals from other wards in the same department were recruited and participated in the study. Providers in the control group cared for terminally ill patients and for patients with reduced consciousness, but they had no direct contact with the Ebola patient. The control participants were not recruited from intensive care units because, at the time of the study, the patient was not receiving intensive care treatment. The 2 groups were balanced with respect to age and occupational characteristics (Table). There was no special psychological support service for health care workers in this hospital. Staff members had received mandatory biweekly training, which included decontamination procedures, technical aspects of diagnostic procedures, and emergency care. In contrast to our hypothesis, no significant differences emerged between the 2 groups with respect to the severity of somatic symptoms, anxiety, depression, and fatigue (Table). Moreover, mean total scores for both groups were at a comparable level to mean scores for the general population (3–5). However, health care professionals who had direct contact with the Ebola patient reported significantly greater social Isolation and felt significantly more need for shorter shift hours. The open responses of participants who experienced social Isolation suggested that their spouses, children, and other relatives had infection-related concerns. Additionally, half of the participants who did not have direct patient contact reported feeling a need for psychological preparation (Table). Nevertheless, almost all health care professionals (97% of those with direct patient contact, 93% of those without direct patient contact) believed that the health care facilities of the hospital were safe. Our investigation of the psychological stress of health care professionals in a Western tertiary care center showed that a well-trained and dedicated team can cope well with the stress of caring for a severely ill Ebola patient. Of note, the direct patient contact group tended to comprise more male participants and more participants living with partners, which may have influenced the experience of psychological stress. No staff member refused to participate in the treatment of the Ebola patient, which underlines the high level of motivation within the team and may render direct comparison to other centers difficult. While the patient was in the Isolation unit, working shifts lasted up to 12 hours, consisting of 2 periods with 3–4 hours of work while wearing personal protective equipment in addition to time spent disinfecting. Most respondents felt that these shifts were too long. We therefore suggest that shift durations should be decreased to 8 hours comprising 2 blocks of 2 hours each for direct patient contact. Shorter shifts should improve staff satisfaction with the working conditions and potentially increase the personal safety of all health care personnel involved in direct patient contact.
Deacons Yeung - One of the best experts on this subject based on the ideXlab platform.
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infection control challenges in setting up community Isolation and treatment facilities for patients with coronavirus disease 2019 covid 19 implementation of directly observed environmental disinfection
Infection Control and Hospital Epidemiology, 2020Co-Authors: Shukching Wong, Ming Leung, Danny W K Tong, Larry Lapyip Lee, Will Lokhang Leung, Frank W K Chan, Jonathan H K Chen, Ivan Hung, Kwokyung Yuen, Deacons YeungAbstract:BACKGROUND: Extensive environmental contamination by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was reported in hospitals during pandemic coronavirus disease 2019 (COVID-19). We highlighted the practice of directly-observed environmental disinfection (DOED) in the community Isolation Facility (CIF) and community treatment Facility (CTF) in Hong Kong. METHODS: CIF (250 single-room bungalows in a holiday camp) was opened on July 24, 2020 to receive step-down patients from hospitals, while CTF (500-bed of open-cubicle inside a conventional hall) was activated on August 1, 2020 to admit newly diagnosed COVID-19 patients from the community. Healthcare workers (HCWs) and cleaning staff received infection control training to reinforce donning and doffing of personal protective equipment and understand the practice of DOED, where the cleaning staff observed patients' and staff activities and then performed environmental disinfection immediately after their use. Supervisors also observed cleaning staff to ensure the quality of work. In CTF, air and environmental samples were collected on day 7, 14, 21, and 28 for SARS-CoV-2 by RT-PCR, while patients' compliance of wearing mask was recorded. RESULTS: Of 291 HCWs and 54 cleaning staff, who managed 243 and 674 patients in CIF and CTF, respectively, from July 24 to August 29, 2020, none of them acquired COVID-19. All 24 air samples and 520 environmental samples collected in the patient area of CTF were negative for SARS-CoV-2. Patients' compliance of wearing mask was 100%. CONCLUSION: With appropriate infection control measures, zero environmental contamination and nosocomial acquisition of COVID-19 among HCWs and cleaning staff could be achieved.
Wanessa Trindade Clemente - One of the best experts on this subject based on the ideXlab platform.
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high positivity of mimivirus in inanimate surfaces of a hospital respiratory Isolation Facility brazil
Journal of Clinical Virology, 2015Co-Authors: Ludmila Karen Dos Santos Silva, Bernard La Scola, Paulo V.m. Boratto, Ketyllen R. Andrade, Erna Geessien Kroon, Gabriel Magno De Freitas Almeida, Thalita Souza Arantes, Wanessa Trindade ClementeAbstract:Abstract Background Mimiviruses have been considered putative emerging pneumonia agents. Pneumonia is a leading cause of death related to infection throughout the world, with approximately 40% of cases presenting unknown etiology. Therefore, identifying new causative agents of community and nosocomial pneumonia is of major public health concern. Objective We evaluated the distribution of these viruses in samples collected from different environments of one of the largest hospitals in Brazilian Southeast. Study design We analyzed, by molecular and virological approaches, the distribution of mimivirus in 242 samples collected from inanimate surfaces in different hospital facilities. Results A significant positivity of mimivirus in respiratory-Isolation-facilities was observed ( p Conclusion Although the role of mimivirus as etiological agents of pneumonia is still under investigation, our results demonstrates interesting correlations that strengthens the need for control over the occurrence of these viruses in hospital facilities.
