Knowledge, attitudes and practices of healthcare workers within an Australian tertiary hospital to managing high-consequence infectious diseases

High-consequence infectious diseases: the conception and development of a multi-disciplinary, interprofessional simulation training programme

BACKGROUND

High-consequence infectious diseases (HCIDs) represent a group of acute infectious diseases with the potential to impact healthcare systems and public health profoundly. Effective management requires a system-based strategy focused on early detection, initiation of infection prevention and control measures, and appropriate use of personal protective equipment (PPE). Inadequate training in the safe use of HCID PPE, and lack of familiarity with key processes such as HCID waste and spills management, exacerbates the risk posed to healthcare workers (HCWs). Enhanced training opportunities are required to ensure that staff are equipped with the necessary knowledge and capabilities to protect themselves from pathogen exposure and infection.

AIM

To create a bespoke interprofessional HCID simulation training programme.

METHODS

A detailed learning needs analysis was undertaken, which identified multiple areas amenable to educational intervention. A full-day HCID simulation programme was developed, providing HCWs the opportunity to practice and gain proficiency in various domains.

FINDINGS

Six interprofessional participants took part in the HCID simulation programme pilot. All six (100%) participants felt that the stated learning objectives had been achieved, and five and one participants found the programme to be extremely useful (83%) or very useful (17%), respectively. Following refinement based on pilot feedback, a further six courses have been run for 38 participants, of whom 97% found the programme to be extremely useful or very useful.

CONCLUSION

The development of a training intervention in the low-frequency, high-risk field of HCIDs had a positive impact. Given the disproportionate impact on HCWs at times of HCID outbreaks, more investment is needed to keep the workforce upskilled.

Construction and application of the core competence course training system for infectious disease specialist nurses

OBJECTIVES

This study aims to construct and apply a training course system which was scientific and comprehensive to foster the core competence of infectious disease specialist nurses.

DESIGN

A two-round Delphi consultation survey was carried out to collect feedback from experts on constructing the training course system of core competence for infectious disease specialist nurses. Besides, a non-randomized controlled experimental study was adopted to check the application effect of the courses.

METHODS

This study adopted a series of methods including group discussion, theoretical analysis and Delphi consultation to draft the training course content of core competence of infectious disease specialist nurses. Twenty-one Chinese experts were invited to participate in the Delphi consultation from November 2021 to December 2021. From October 2022 to January 2023, a total of 105 infectious disease specialist nurses from two training bases were selected by the convenience sampling method, of which the nurses in one training base were the control group and the nurses in the other training base were the observation group. The observation group was trained by the constructed core competence training course. Questionnaire evaluation was used to compare the core competence of infectious disease specialist nurses and the training effect.

RESULTS

The experts, regarded as the authorities on the subject, were highly motivated in this study. Besides, they reached a consensus on the results. The final training course system of core competence for infectious disease specialist nurses focused on 5 competence modules and was composed of 12 categories of courses with 66 classes and corresponding objectives. The core competence scores of the observation group were significantly higher than those in the control group after training (P < 0.05), which proved the training system can effectively enhance the core competence of infectious disease specialist nurses.

CONCLUSIONS

The research methods embodied scientific and precise properties. The course system was comprehensive in content and reliable in results. It could serve as a reference for training infectious disease specialist nurses.

Are pediatric nurses prepared to respond to monkeypox outbreak?

BACKGROUND

Emphasizing the crucial significance of maintaining a national nursing workforce well-prepared with the necessary knowledge, skills, and abilities to respond effectively is the growing frequency of natural and environmental disasters, coupled with public health emergencies such as the COVID-19 pandemic. So, the study aimed to explore pediatric nurses' preparedness to monkeypox outbreak, and their stress during this outbreak in Egypt.

METHODS

A cross-sectional study was conducted on a 416 nurses direct care for children at selected governmental hospitals in Egypt. Demographic form, Questionnaire for Infectious Disease Outbreak Readiness & Preparedness, factors affecting nurses' preparedness, and the generalized anxiety disorders scale-7 were the tools of the study.

RESULTS

(81.5%) of studied nurses had unsatisfactory level of preparedness to monkeypox outbreak. (96.4%) and (95.4%) of them were affected their preparedness by high workload and inconsistent income with the of risk of infection factors. Also, (57.2%) of them had high stress level.

CONCLUSIONS

The study revealed the importance of ensuring adequate supplies of PPE are available and provided, and protocols must be implemented to ensure availability in case of an outbreak. Moreover, nurse staffing levels and workload distribution should be regularly reviewed to create reasonable nurse-patient ratios.

The biosafety incident response competence scale for clinical nursing staff: a development and validation study

AIMS

This study was designed to develop a biosafety incident response competence scale and evaluate its validity and reliability among clinical nurses.

DESIGN

This study employed a sequential approach, comprising four phases: (1) the establishment of a multidimensional conceptual model, (2) the preliminary selection of the items, (3) further exploration and psychometric testing of the items, (4) the application of the scale among clinical nurses.

METHODS

The biosafety incident response competence conceptual model was developed through literature review and the Delphi method. A total of 1,712 clinical nurses participated in the preliminary items selection, while 1,027 clinical nurses were involved in the further psychometric testing from July 2023 to August 2023. The item analysis, exploratory factor analysis and confirmatory factor analysis were conducted to evaluate the construct validity. Reliability was measured using Cronbach's alpha, split-half reliability, and test-retest reliability, while validity analysis included content validity, structural validity, convergent validity, and discriminant validity. From September to November 2023, we conducted a survey using the established scale with a total of 4338 valid questionnaires collected. T-test and variance analysis was employed to determine potential variations in biosafety incident response competence based on participants characteristics.

RESULTS

The final scale is composed of 4 factors and 29 items, including monitoring and warning abilities, nursing disposal abilities, biosafety knowledge preparedness, and infection protection abilities. The explanatory variance of the 4 factors was 75.100%. The Cronbach's alpha, split-half reliability and test-retest reliability were 0.974, 0.945 and 0.840 respectively. The Scale-level content validity index was 0.866. The Average Variance Extracted of the 4 factors was larger than 0.5, the Construct Reliability was larger than 0.7, and the Heterotrait-Monotrait ratio were less than 0.9. There were significant differences in the scores of response competence among nurses of different ages, working years, titles, positions, departments, marital status and participation in biosafety training (all P < 0.05).

CONCLUSIONS

The biosafety incident response competence scale for nurses exhibits satisfactory reliability and validity, making it a valuable tool for assessing clinical nurses' abilities in responding to biosafety incidents.

The PATH to PPE Mastery - Programme for Assessment and Training in HCID (High Consequence Infectious Diseases) PPE (Personal Protective Equipment), Mastery

Background

High Consequence Infectious Diseases (HCIDs), have the potential to cause pandemics and require particular focus for preparedness due to their high mortality rates. The application of Personal Protective Equipment (PPE) for HCIDs is complex and carries significant risk of Health Care Worker (HCW) contamination if done incorrectly. Previous reviews have reported a lack of information on the nature of training provided and the ideal timing of repeat training to best retain skills. Simulation Based Mastery Learning (SBML) is a methodology for skill acquisition which encompasses deliberate practice and repeated assessment until the learner achieves a pre-set Mastery standard. SBML has been demonstrated to improve competence, skill retention and patient outcomes in other clinical procedures. SBML has not been previously studied or utilised in HCID PPE training.

Aim

We aimed to increase the likelihood of safe clinical practice by evidencing that Lothian modified SBML for PPE effectively prepares our priority learners.

Methods

A quasi-experimental within group post-test design was used. Learners undertook a modified SBML programme which included two-hour asynchronous and two-hour synchronous components.

Findings

11 learners (10 infectious diseases registrars and 1 infectious diseases consultant) were enrolled in the programme with 8 completing all stages, all of whom achieved the Mastery passing standard. The resources were highly rated by learners with the exemplar videos of skills highlighted as particularly useful. Self-assessed preparedness for each skill increased following pre-learning and synchronous sessions.

Conclusion

Modified SBML can be used as an effective methodology for the training and assessment of HCWs in the donning and doffing of HCID PPE.

Are nurses prepared to respond to next infectious disease outbreak: A narrative synthesis

Aim

The review aimed to present a synthesis of nurses' preparedness for infectious disease and the components of emergency preparedness.

Design

Narrative synthesis.

Methods

A systematic search and screening for relevant studies were conducted to locate the relevant articles. The included studies were examined for scientific quality using the Mixed Methods Appraisal Tool. The findings of included studies were synthesized by a narrative synthesis approach.

Results

Totally 15 studies were included, and 4 themes associated with nurses' preparedness for pandemic were identified: knowledge and skills, psychological preparation, external resources, and attitude and intention.

Conclusions

Most nurses express a positive willingness to respond to epidemics, although they do not believe they are adequately prepared. Some measures should be taken for improving nurses' emergency preparedness, including providing ongoing training, protective equipment, safe working environment and psychological intervention, improving nurses' resilience and accelerating the sharing of scientific information about epidemics.

Environmental hygiene, knowledge and cleaning practice: a phenomenological study of nurses and midwives during COVID-19

Background

Environmental cleanliness is a fundamental tenet in nursing and midwifery but often overshadowed in practice. This study explored nurses’ and midwives’ knowledge and experiences of infection prevention and control (IPC) processes and cleaning, and perceptions about workplace risk-management during COVID-19.

Methods

Six registered and enrolled nurses (one with dual midwife qualifications) were recruited. In-depth telephone interviews were analyzed using Colaizzi's phenomenological method.

Results

Four major themes were identified: Striving towards environmental cleanliness; Knowledge and learning feeds good practice; There's always doubt in the back of your mind; and COVID has cracked it wide open. These articulate the nurses’ and midwives’ experiences and knowledge of IPC, particularly during COVID-19.

Discussion

The findings emphasize the dynamic, interdependent nature of clinical (time, staff knowledge and compliance, work processes, hospital design) and organizational contexts and environmental cleanliness, which must be constantly maintained. COVID-19 opened up critical insights regarding poor past practices and lack of IPC compliance.

Conclusions

COVID-19 has highlighted the criticality of environmental cleanliness within clinical and community settings. Evidence-based, experiential learning is important for nurses and midwives at all career stages, but provides only one solution. Clinician-led hospital design may also reduce the spread of infection; thus, promoting better patient care.

Occupational risk factors of contracting COVID-19 among health workers: A systematic review

BACKGROUND

With the spread of COVID-19 and the worsening global prevention and control situation, the risk of infection faced by health workers has been unprecedented. It is necessary to fully understand the occupational risks of health workers to protect them and reduce their risk of infection.

OBJECTIVE

This study aimed to obtain comprehensive and detailed information on occupational risk factors of infectious diseases for HWs in different dimensions and to propose control strategies for three risk dimensions to protect HWs who are at high risk of infection during the pandemic.

METHODS

A total number of 619 articles published from 2010 to 2021 were searched to conduct bibliometric analysis, which were retrieved in the Web of Science database with defined search terms. There were 26 articles met the criteria, and they were screened to identify occupational risk factors.

RESULTS

We conducted an analysis of cited institutions, co-citation network analysis of journals, and references from bibliometric analysis. Nine risk factors were extracted, and they were classified and sorted into three dimensions. Infection control strategies for each dimension were proposed.

CONCLUSIONS

The risk of infection faced by HWs is unprecedented. Medical institutions should pay more attention to the nine risk factors that we identified and use the three risk dimensions to carry out risk identification and infection control to reduce the infection risk of HWs and protect them better.