Calculating Return to Work COVID-19 policies are a balancing act for hospitals
Calculating Return to Work COVID-19 policies are a balancing act for hospitals

Calculating Return to Work COVID-19 policies are a balancing act for hospitals

Investigators concluded that HCPs can safely return to work after a 7-day quarantine if they test negative for COVID-19 on days 5 to 7.

When it comes to staffing hospitals, public and private health officials strive to strike a balance between the safety of health professionals (HCPs) and the ability of institutions to function properly, especially during COVID-19 increases. The issue came to light last December when the Centers for Disease Control and Prevention (CDC) in view of critical staff shortages in the healthcare sector, which has lost about 20% of its workforce since the start of the COVID-19 pandemic, shortened the recommended isolation period for healthcare professionals exposed to COVID-19 in high-risk situations from 10 to 7 days (Sharon Ward-Fore, MS, MT[ASCP]CIC, FAPIC, a member of Infection Control Today® [ICT®] Editorial Board [EAB]clearly stated what should and must not of the recommendations in one Questions and answers in January).

National Nurses United, a union representing more than 175,000 members, immediately pushed back, and argues that the recommendation puts nurses on the front lines of the COVID-19 wars at risk. And despite a recent minor increase When hiring in the healthcare sector, hospitals and other healthcare facilities still have to deal with staff shortages.

Investigators from the University of Pittsburgh Medical Center wanted to see what the effects of shortened quarantines could be. They concluded that HCPs can safely return to work (RTW) after 7 days of quarantine if they test negative for COVID-19 on days 5 to 7.

“To optimize staff health, patient safety and health capacity, extraordinary efforts are needed to address contingency and crisis planning to mitigate staff shortages before the next wave of COVID-19 cases,” investigators reported in a examination published in American Journal of Infection Control (AJIC). “Implementing an HCP early RTW program is a strategy to increase staff availability and therefore reduce the burden of staff shortages on healthcare staff while maintaining a low risk of SARS-CoV-2 transmission.”

The observational study included HCP working on an integrated health care system at 40 hospitals in central Pennsylvania, where employees faced a higher risk of either being exposed to COVID-19 in the workplace or in a non-domestic community of 4 or fewer days. HCPs could return to work 8 days after exposure “if they remained asymptomatic through day 7 with day 5-7 SARS-CoV-2 nucleic acid amplification test result negative,” the study said.

Investigators tracked 384 HCPs between January 4 and June 25, 2021, which followed the recommendations. Of the 384 participants, 333 (86.7%) remained asymptomatic. Of these, 323 (97%) tested negative and were thus eligible to return to work.

“The median day of early RTW was 8 (range 6-9, IQR 8-8),” the study said. “The mean number of days saved from joblessness was 1.84 (SD 0.52). A total of 297 (92%) HCP performed RTW ≤ 10 days from exposure, and days saved from joblessness were 546.48 . “

Investigators note that COVID-19 may last for years, and Omicron may not be the last variant to emerge and challenge health systems. The way these systems can meet future challenges will be to be as fully staffed as possible. 10-day quarantine was established as a “conservative” way to manage the risk of exposure to COVID-19, the study notes. While the CDC offers quarantine recommendations, many hospitals and other health facilities will use different standards.

This is a point that was recently made by Linda Spaulding, RN-BC, CIC, CHEC, CHOP, an infection prevention consultant and another ICT® EAB member when she said that “if nurses are still sick on day 5, they should not return to work yet. But they feel pressured by their hospital to return to work due to lack of care. “

Spaulding added that infection prevention experts cannot provide much help to stressed nurses. “IPs can listen to the nursing staff, but they are largely powerless if the administration [of a hospital] requires them to return to work, ”says Spaulding. “From what I hear from nurses, they will try hard to take care of patients with COVID-19. But as soon as this increase is over, they will leave nursing, and if there is a new increase, we will have more less staff than we have now. “

Investigators in AJIC study indicates that the system they use is built in flexibility.

“We were able to flex the 7-day quarantine period in the program back to a 10-day quarantine period where staff restrictions eased and resume the 7-day early RTW program as the pandemic increased again,” the study said. “As a learning health system, we used these results to inform about new methods of Employee Health sample collection, including a symptomatic self-testing program with results typically available within 1 day.

Investigators concluded that “adaptability is crucial in pandemic response, as is real-time evaluation of interventions such as the early RTW program. The results of this program were reviewed no less than weekly to ensure a safe working environment for HCP and safe patient care.”

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