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INTRODUCTION: Due to the SARS-CoV-2 pandemic, adjustments in patient and visitor traffic were made in hospitals to limit viral exposure. The primary objective of our study was to compare the breastfeeding success of healthy newborns in a maternity ward during the 2020 lockdown period compared with the same period in the previous year. MATERIAL AND METHODS: Single-center comparative study based on prospectively collected data. All neonates born alive, from a single pregnancy, and with a gestational age greater than 36 weeks were considered for this study. RESULTS: 309 infants born in 2020 and 330 born in 2019 were included. Among women who desired to exclusively breastfeed, the rate of exclusive breastfeeding at discharge from the maternity ward was higher in 2020 than in 2019 (85 vs. 79%; p = 0.078). After logistic regression analysis adjusted for potential confounders (i.e., maternal BMI, parity, mode of delivery, gestational age, and size at birth), study period remained significantly and independently associated with exclusive breastfeeding at discharge (OR [95% CI] = 1.645 [1.005; 2.694]; p = 0.046). Newborns born in 2020 were less likely to have weight loss ≥10% than those born in 2019 (OR [95% CI] = 2.596 [1.148; 5.872]; p = 0.017) but had similar need for phototherapy (p = 0.41). CONCLUSION: The success of exclusive breastfeeding during the 2020 lockdown period was increased compared with the same period in 2019.
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Lactancia Materna , COVID-19 , Lactante , Recién Nacido , Humanos , Femenino , Embarazo , Preescolar , Pandemias , Salud del Lactante , COVID-19/epidemiología , SARS-CoV-2 , Control de Enfermedades TransmisiblesRESUMEN
BACKGROUND: There is limited data to support the impact of the COVID-19 pandemic on hand hygiene compliance among hospital visitors. METHODS: We monitored hand hygiene compliance among university hospital visitors in Osaka, Japan by direct observation, from December 2019 to March 2022. During this time, we measured the amount of coverage time dedicated to COVID-19 related news on the local public television channel and the number of confirmed cases and deaths. RESULTS: Over 148 days, 111,071 visitors hand hygiene compliance was monitored. The baseline compliance was 5.3% (213 of 4,026) in December 2019. From late January 2020, compliance rose significantly to almost 70% in August 2020. It remained at a level of 70%-75% until October 2021, after which, the compliance slowly declined to the mid-60% range. The number of newly confirmed cases and deaths were not related to the change in compliance, but the association between the on-air time of COVID-19-related news and compliance was statistically significant. CONCLUSIONS: Hand hygiene compliance dramatically increased following the COVID-19 pandemic. The role of television in increasing hand hygiene compliance was significant.
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COVID-19 , Higiene de las Manos , Humanos , COVID-19/prevención & control , Pandemias/prevención & control , Brotes de Enfermedades , Hospitales Universitarios , Adhesión a Directriz , Desinfección de las ManosAsunto(s)
COVID-19 , Humanos , SARS-CoV-2 , Tokio/epidemiología , Japón/epidemiología , Hospitales , Inmunoglobulina G , Prueba de COVID-19RESUMEN
OBJECTIVE: Due to the COVID-19 pandemic, a number of changes to maternity care were rapidly introduced in all countries, including Australia, to reduce the risk of infection for pregnant women and their care providers. While many studies have reported on the negative effects of these changes, there is a paucity of evidence on factors which women and their providers perceived as positive and useful for future maternity care. DESIGN: Data was analysed from the Birth in the time of COVID-19 (BITTOC 2020) study survey. Conventional content analysis and descriptive statistics were used to analyse the data and examine which aspects of COVID-amended care women experienced as positive. Data from women were compared to data from midwives. SETTING: This project took place in Australia in 2020-2021. PARTICIPANTS: The survey was distributed to women who gave birth and midwives who worked in Australia during the COVID-19 pandemic (March 2020 onwards). MEASUREMENTS AND FINDINGS: Women reported a variety of positives from their maternity care during COVID-19. These included both care-related factors as well as contextual factors. The most commonly mentioned positives for pregnant and postnatal women were care-related, namely fewer visitors in hospital, having increased access to telehealth services. These were also the most commonly reported positives by midwives. Having midwifery continuity of care models, giving birth at home and having their partner work from home were also highlighted by women as positives. KEY CONCLUSIONS: Despite the negative effect of COVID-19-related restrictions on maternity care, a variety of changes were viewed as positive by both women and midwives, with strong agreement between the two groups. IMPLICATIONS FOR PRACTICE: These findings provide evidence to support the inclusion of these positive elements of care and ensure that the lessons learned from the pandemic are utilised to improve maternity care in Australia going forward.
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COVID-19 , Servicios de Salud Materna , Partería , Australia/epidemiología , Femenino , Humanos , Masculino , Pandemias , Parto , EmbarazoRESUMEN
BACKGROUND: Tokyo, the capital of Japan, is a densely populated city of >13 million people, so the population is at high risk of epidemic severe acute respiratory coronavirus 2 (SARS-CoV-2) infection. A serologic survey of anti-SARS-CoV-2 IgG would provide valuable data for assessing the city's SARS-CoV-2 infection status. Therefore, this cross-sectional study estimated the anti-SARS-CoV-2 IgG seroprevalence in Tokyo. METHODS: Leftover serum of 23,234 hospital visitors was tested for antibodies against SARS-CoV-2 using an iFlash 3000 chemiluminescence immunoassay analyzer (Shenzhen YHLO Biotech, Shenzhen, China) with an iFlash-SARS-CoV-2 IgG kit (YHLO) and iFlash-SARS-CoV-2 IgG-S1 kit (YHLO). Serum samples with a positive result (≥10 AU/mL) in either of these assays were considered seropositive for anti-SARS-CoV-2 IgG. Participants were randomly selected from patients visiting 14 Tokyo hospitals between September 1, 2020 and March 31, 2021. No participants were diagnosed with coronavirus disease 2019 (COVID-19), and none exhibited COVID-19-related symptoms at the time of blood collection. RESULTS: The overall anti-SARS-CoV-2 IgG seroprevalence among all participants was 1.83% (95% confidence interval [CI], 1.66-2.01%). The seroprevalence in March 2021, the most recent month of this study, was 2.70% (95% CI, 2.16-3.34%). After adjusting for population age, sex, and region, the estimated seroprevalence in Tokyo was 3.40%, indicating that 470,778 individuals had a history of SARS-CoV-2 infection. CONCLUSIONS: The estimated number of individuals in Tokyo with a history of SARS-CoV-2 infection was 3.9-fold higher than the number of confirmed cases. Our study enhances understanding of the SARS-CoV-2 epidemic in Tokyo.
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COVID-19 , Anticuerpos Antivirales , Estudios Transversales , Hospitales , Humanos , Inmunoglobulina G , SARS-CoV-2 , Estudios Seroepidemiológicos , Tokio/epidemiologíaRESUMEN
BACKGROUND: Indoor positioning systems (IPS) have become increasingly important for several branches of the economy (eg, in shopping malls) but are relatively new to hospitals and underinvestigated in that context. This research analyzes the intention of actors within a hospital to use an IPS to address this gap. OBJECTIVE: To investigate the intentions of hospital visitors and employees (as the main actors in a hospital) to use an IPS in a hospital. METHODS: The reasoned action approach was used, according to which the behavior of an individual is caused by behavioral intentions that are affected by (1) a persuasion that represents the individual's attitude toward the behavior, (2) perceived norms that describe the influence of other individuals, and (3) perceived norms that reflect the possibility of the individual influencing the behavior. RESULTS: The survey responses of 323 hospital visitors and 304 hospital employees were examined separately using SmartPLS 3.3.3. Bootstrapping procedures with 5000 subsamples were used to test the models (one-tailed test with a significance level of .05). The results show that attitude (ß=.536; P<.001; f²=.381) and perceived norms (ß=.236; P<.001; f²=.087) are predictors of hospital visitors' intention to use an IPS. In addition, attitude (ß=.283; P<.001; f²=.114), perceived norms (ß=.301; P<.001; f²=.126), and perceived behavioral control (ß=.178; P=.005; f²=.062) are predictors of hospital employees' intention to use an IPS. CONCLUSIONS: This study has two major implications: (1) our extended reasoned action approach model, which takes into account spatial abilities and personal innovativeness, is appropriate for determining hospital visitors' and employees' intention to use an IPS; and (2) hospitals should invest in implementing IPS with a focus on (a) navigational services for hospital visitors and (b) asset tracking for hospital employees.
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Hospitales , Intención , Actitud , Humanos , Encuestas y CuestionariosRESUMEN
BACKGROUND: Different case finding approaches have been used to identify early COPD. The objective of this study was to assess the feasibility and the yield of opportunistic early COPD case finding in visitors to a large medical centre. PATIENTS AND METHODS: From May 2014 to June 2017, we consecutively recruited adults aged ≥ 18 years visiting the Shaare Zedek Medical Center, in Jerusalem. Our 3-step intervention included: a) pre-screening for symptoms with the 5-item "Could it be COPD?" questionnaire (score= 0-5 pts); b) pre-BD spirometry; and c) referral to a caregiver. Airflow obstruction was defined by a FEV1/FVC < 0.7. Spirometry results were used as an incentive to promote smoking cessation and quit rates were verified by phone survey 3 months after the intervention. RESULTS: A total of 1001 subjects (956 smokers; 45 ex-smokers) were recruited. Mean (SD) age was 48.3 years (13.5). Airflow obstruction was detected in 180 (18%) subjects of whom 142 (78.9%) were unaware of it, including 27 subjects with severe (50% ≥ FEV1 ≤ 30% predicted) (n=25) or very severe (FEV1 < 30% predicted) (n=2) obstruction. Multiple logistic regression analysis found that age, BMI, cigarette smoking (p.y.) and a "Could it be COPD?" questionnaire score ≥ 3 points correctly classified 83.3% of cases of airflow obstruction. At follow-up, 54.5% of participants reported smoking as usual, 30.9% reduced smoking [mean (SD) = 10.1 ± 7.8 cigarettes/day], 7.4% increased smoking [mean (SD) = 9.2 ± 6.3 cigarettes/day] and 7.2% claimed smoking cessation. Among obstructed subjects, 38.7% had visited a physician because of COPD, while 20.7% were taking a new respiratory medication. CONCLUSION: Early COPD case finding was feasible and effective in identifying undiagnosed airflow obstruction among visitors to a medical centre. Smoking cessation counselling based on spirometry promoted a small but clinically meaningful cessation rate.
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Enfermedad Pulmonar Obstructiva Crónica , Fumadores , Adulto , Ex-Fumadores , Volumen Espiratorio Forzado , Humanos , Persona de Mediana Edad , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Fumar/efectos adversos , EspirometríaRESUMEN
BACKGROUND: Seroprevalence studies of coronavirus disease 2019 (COVID-19) from many countries have shown that the number of undiagnosed missing cases is much larger than that of confirmed cases, irrespective of seroprevalence levels. Considering the strategy of Korea entailing massive testing and contact tracing from the beginning of epidemic, the number of undiagnosed missing cases in Korea may be negligible. This study was conducted to estimate the seroprevalence of COVID-19 among individuals who were never diagnosed with COVID-19 in Daegu, the epicenter of COVID-19 epidemic in Korea. METHODS: Serologic testing for immunoglobulin G antibody based on immunochromatographic assay was conducted in 103 patients and 95 guardians aged 18 to 82 years without any history of COVID-19 diagnosis, who visited outpatient clinics of a single university-affiliated hospital from May 25 to June 5, 2020. RESULTS: The estimated seroprevalence was 7.6% (95% confidence interval, 4.3%-12.2%) with 15 positive cases. Among them, only one had a polymerase chain reaction (PCR)-confirmed case among their close contacts and 13 did not experience COVID-19-related symptoms. Seroprevalence was similar between patients and guardians. Based on this figure, the number of undiagnosed missing cases in Daegu was estimated to be a dozen times more than the number of confirmed cases based on PCR testing. CONCLUSION: Despite the limitation of a small and unrepresentative sample, this is the first study on seroprevalence of COVID-19 in Korea. Our study suggested that the number of undiagnosed missing cases was substantial even with the stringent strategy adopted in Korea, similar to that of other countries.
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Anticuerpos Antivirales/sangre , Infecciones por Coronavirus/epidemiología , Inmunoglobulina G/sangre , Neumonía Viral/epidemiología , Estudios Seroepidemiológicos , Enfermedades no Diagnosticadas/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Instituciones de Atención Ambulatoria , Betacoronavirus/inmunología , COVID-19 , Trazado de Contacto , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/diagnóstico , Femenino , Humanos , Inmunoglobulina G/inmunología , Masculino , Tamizaje Masivo/métodos , Persona de Mediana Edad , Pandemias , Neumonía Viral/sangre , Neumonía Viral/diagnóstico , Reacción en Cadena de la Polimerasa , República de Corea/epidemiología , SARS-CoV-2 , Pruebas Serológicas , Encuestas y Cuestionarios , Enfermedades no Diagnosticadas/virología , Adulto JovenRESUMEN
This research aimed to inform nursing practice and policy by identifying satisfying and problematic experiences of hospital visitors during the hospitalisation episode of a significant other. An extensive contextual review revealed that healthcare systems in advanced economies face multiple pressures and that in England, the government leaves the determination of hospital visiting rules to individual trusts. The analytic lens of liminality provides rich interpretations of visitors' accounts and demonstrates the importance to visitors of structure (hospital rules and systems) and communitas (social bonding among liminal personae). Supportive hospital structures reduce the challenges of liminality and increase satisfaction. The data further suggest an extension to current understandings of liminality. Strong structure and successful communitas permit a safe exit from liminality after the hospitalisation episode for visitors with a close emotional bond with the patient.
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Hospitales/normas , Satisfacción Personal , Visitas a Pacientes/psicología , Adulto , Anciano , Anciano de 80 o más Años , Inglaterra , Femenino , Humanos , Masculino , Persona de Mediana Edad , Políticas , Investigación CualitativaRESUMEN
Aim To investigate participants' experiences of visiting hospitalised friends and family members in adult acute medical or surgical wards in NHS hospitals in England, to improve knowledge of hospital visiting practices and to inform future policy-making and professional practice. Method A review of the contextual influences and the literature identified that hospital visitors might experience many of the characteristics of liminality, which is a state of being between two social structures or ways of being. In 2013, a total of 17 semi-structured, recorded and transcribed interviews were conducted with participants who had been hospital visitors in the period 2011-2013. The transcribed interviews underwent a thematic analysis. Liminality was then used as an analytic lens, and was central to the theoretical framework that was constructed to further consider the experiences of hospital visitors. Findings Participants experienced the hospitalisation of their friend or family member and their subsequent role as hospital visitors as a suspension of their everyday lives. Liminality was a predominant and consistent theme of the interviews. Five main themes of liminality were identified in relation to hospital visitors' experiences: total obedience; loss of status; ambiguity and being betwixt and between; uncertainty; and structure and communitas. The findings suggested that nurses consider the area behind the nurses' station as 'back stage'; a place they can use for downtime, socialising and computer work. In contrast, hospital visitors perceive the nurses' station to be a continuation of the ward, where they expect professional 'front stage behaviour' from staff. Conclusion When hospital visitors, already discomfited in their liminal status, encounter nurses' 'back-stage behaviour' at the nurses' station, their feelings of marginalisation, exclusion and mistrust increase. This may lead them to judge that the nurses lack professionalism and care, which can lead them to make complaints. Increased awareness of hospital visitors' perceptions might result in fewer complaints, and enable more NHS resources to be directed at improving patient care.
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Infection transmission in healthcare facilities is a growing concern. Visitation to healthcare facilities is very common, though the potential role of visitors in the transmission of infection is unknown. Although transmission-based precautions are generally used to prevent the spread of organisms in healthcare settings by healthcare staff, the applicability of these precautions to visitors is unclear. Decisions regarding whether to implement transmission-based precautions among visitors should take into account the organism of concern and means of transmission as well as factors pertaining to the visitor and the healthcare setting. The role of visitors as vectors for organism transmission in the healthcare setting and the potential benefits and adverse consequences of visitor adherence with transmission-based precautions are important areas for additional research.