BACKGROUND

Healthcare workers’ (HCWs) willingness to report to work despite personal risk is a requisite for an effective pandemic response. At present, there are no local studies that have examined the factors affecting willingness to report to work during the COVID-19 pandemic.

To determine the factors associated with willingness to report to work during COVID-19 pandemic among healthcare workers in a tertiary government hospital.

This was a cross sectional study among the nursing staff (nursing attendants, nurses), doctors (residents, fellows), medical technologists, radiologic technologists, and respiratory technicians in a tertiary government hospital, who were employed from January 2021 to January 2022. Data was collected through an online questionnaire and was analyzed using SPSS.

A total of 311 participants included in the study. The median age of the respondents was 34 (29-46) years old. More than a third of the workers were nurses (37%) followed by residents and fellows (34%), nursing attendants (19%), radiologic technologists, medical technologists, and respiratory technicians (10%). Over 4 out of 5 were assigned in a non-COVID area while 11% were assigned in the COVID area. The odds of willingness to report to work is 60% lower among males compared to females. On the other hand, the odds of willingness to report to work was 78% lower among nurses and 84% lower among residents and fellows compared to medical technologist, radiologic technologists, and respiratory therapists. The median rating of the staff on willingness to report to work was 80% (60-90), and 73% of respondents were willing to report to work during the entire COVID-19 pandemic.

Factors that were associated with willingness to report to work were female gender and occupation (radiologic technologists, medical technologists, respiratory technicians).

Background: In a low resource setting, strategies to optimize Personal Protective Equipment (PPE) supplies are being observed. Alternative protective measures were identified to protect health care personnel during delivery of care Objective: To provide list of recommendations on alternative protective equipment during this Coronavirus Disease 2019 (COVID-19) pandemic Methodology: Articles available on the various research databases were reviewed, appraised and evaluated for its quality and relevance. Discrepancies were rechecked and consensus was achieved by discussion. Recommendations: The use of engineering control such as barriers in the reception areas minimize the risk of healthcare personnel. Personal protective equipment needed are face shields or googles, N95 respirators, impermeable gown and gloves. If supplies are limited, the use of N95 respirators are prioritized in performing aerosol-generating procedures, otherwise, surgical masks are acceptable alternative. Cloth masks do not give adequate protection, but can be considered if it is used with face shield. Fluid-resistance, impermeable gown and non-sterile disposable gloves are recommended when attending to patients suspected or confirmed COVID-19. Used, soiled or damaged PPE should be carefully removed and properly discarded. Extended use of PPE can be considered, while re-use is only an option if supplies run low. Reusable equipment should be cleaned and disinfected every after use Conclusion In supplies shortage, personal protective equipment was optimized by extended use and reuse following observance of standard respiratory infection control procedures such as avoid touching the face and handwashing. The addition of physical barriers in ambulatory and triage areas add another layer of protection
Personal Protective Equipment ; Triage

Introduction: Annual health examinations are a crucial component of health promotion and sickness prevention. A hospital cannot fulfill its core objective of helping people if its employees are not physically, intellectually, and socially fit. Objective: The purpose of this study was to determine the health perception and level of awareness regarding the Annual Physical Examination of Jose R. Reyes Memorial Medical Center (JRRMMC) employees. Methods: The study utilized the descriptive method of research and an online survey questionnaire were adopted and constructed. Results: One hundred fourteen participants who completed the survey, 67.5% were female, and 32.5% were male. Majority of the respondents were 31-40 ages or 43.9%. 43.9 % were from the nursing/supervisor/officers. In terms of health perception in various indicators, the respondents were concerned about their health. The overall mean of 3.7105 (SD=0.48884) shows in general that respondents were very aware of the level of preventive care. Conclusions The findings suggested that the majority of respondents were aware of the importance of annual physical examination in terms of the level of preventive care insignificant to their health perceptions.

Background: Dyspnea also referred to as shortness of breath or breathlessness is defined as “a subjective experience of breathing discomfort that consists of qualitatively distinct sensations that vary in intensity.” Dyspnea is a symptom of the disease, rather than a disease itself. Its etiology can be designated as arising from four primary categories: respiratory, cardiac, neuromuscular, psychogenic, systemic illness, or a combination of these. Objective: The general objective in developing this guideline is to improve the quality and outcomes of care to adult patients with dyspnea or shortness of breath in primary care and outpatient setting. Methods The ADAPTE process was utilized in the development of the initial guideline recommendations where the following steps were followed: 1) definition of clinical questions, 2) searching, screening and appraisal of guidelines, 3) decision and selection of evidence and 4) iterative drafting of guideline recommendation was done. The retrieved guidelines were systematically evaluated for their quality and validity using the Appraisal of Guidelines for Research & Evaluation (AGREE) II Instrument, which is a tool developed to assess the methodological quality of practice guidelines. If the adopted guideline did not have recommendations for our clinical question, we developed the recommendations de novo using the GRADE approach. We prioritized retrieving systematic reviews and meta-analysis articles that are relevant to our clinical questions. In the development of recommendations, the guideline development team prioritized the interventions that address the following outcomes i.e., decrease in severity of dyspnea, resolution of dyspnea, improved quality of life and decrease mortality. Data from the articles were extracted and the evidence was then summarized and appraised based on the type of study. The recommendations were then developed by the team as the initial draft that was subjected to external review and consensus panel discussion for finalization.
Outpatients ; Dyspnea ; Primary Health Care

BACKGROUND

The COVID-19 pandemic had a profound impact on medical education, particularly in Family and Community Medicine training programs. This study aimed to assess the impact in the Philippines by comparing the number of cases and procedures before and during the pandemic, as well as the adaptations made by these programs.

The objective of this study was to determine the effect of the COVID-19 pandemic on Family and Community Medicine training in the Philippines by comparing the average number of cases and procedures done before and during the pandemic and the changes implemented by the different accredited training programs.

A cross-sectional study utilizing an explanatory sequential mixed methods approach was undertaken. The quantitative portion collected data on cases and procedures from the participating institutions’ residents using the standardized checklist of the Philippine Academy of Family Physicians. The qualitative portion was done through a focused group discussion (FGD) following a prepared set of FGD questions. Analysis of variation (ANOVA) was used to compare the average cases seen and procedures across the four years and content analysis for the qualitative data.

There was a significant decrease in the average number of adult and pediatric cases during the pandemic years (2020-2021) compared to before (2018-2019). Various organ systems cases such as neurology, ophthalmology, dermatology, and gastrointestinal, showed significant differences (p-value<0.05) were found for several organ system cases when comparing the years before (2018-2019) and during the pandemic (2020-2021), including neurology, ophthalmology, ENT, dermatology, cardiology, gastrointestinal, genitourinary, reproductive health, musculoskeletal, and endocrinology cases. The trainers adjusted training activities to support the hospital's COVID-19 response and that prompted an abrupt shift to online strategies for patient consultations, teaching sessions, and examinations.

The COVID-19 pandemic led to a reduction in the variety of cases and procedures in Family and Community Medicine training, impacting the fulfillment of specialty training requirements. However, it also drove innovation through the integration of technology, including online teaching methods. These experiences underscore the importance of resilience and adaptability in medical education and offer valuable lessons for future training programs, potentially leading to improvements in training and patient care through innovative methodologies.

Background: Local government units conduct community – based responses to control spread of COVID-19 infection. Initiatives include city-wide disinfecting operations on streets and establishments, and mist spraying outside houses, vehicles, and even directly on persons. Objective: To provide a list of recommendations on the different disinfection strategies applicable for use in the community Methodology: Articles and guidelines about community disinfection were searched in various research databases. All evidencebased recommendations were reviewed, appraised, evaluated and summarized Recommendations: General disinfection in households and community recommends use of diluted bleach solution of 75ml Sodium hypochlorite in 3.8L or 1 gallon of water (1000ppm). It is recommended to clean and disinfect frequently touched surfaces such as tables, doorknobs, light switches, handles, desks, toilets, faucets, sinks and electronics. In disinfecting local quarantine facilities, all surfaces must be regularly cleaned using damp cleaning cloth and mops. Ethyl alcohol (70%) is used for small surfaces and well-ventilated spaces while diluted household bleach is used for surface disinfection. Spraying or fogging with ethyl alcohol or bleach disinfectant may be hazardous and has no proven benefit on disease prevention and control Conclusion The use of properly diluted household disinfectant solution for direct surface cleaning is an effective infection control measure in the community setting. Available evidence, however, recommends against the use of spraying, misting or fogging
Coronavirus ; Infection Control