Browsing by Author "Wiens, Karen"

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    Patient and ward related risk factors in a multi-ward nosocomial outbreak of COVID-19: Outbreak investigation and matched case–control study
    (2023-03-22) Leal, Jenine; O’Grady, Heidi M.; Armstrong, Logan; Dixit, Devika; Khawaja, Zoha; Snedeker, Kate; Ellison, Jennifer; Erebor, Joyce; Jamieson, Peter; Weiss, Amanda; Salcedo, Daniel; Roberts, Kimberley; Wiens, Karen; Croxen, Matthew A.; Berenger, Byron M.; Pabbaraju, Kanti; Lin, Yi-Chan; Evans, David; Conly, John M.
    Abstract Background Risk factors for nosocomial COVID-19 outbreaks continue to evolve. The aim of this study was to investigate a multi-ward nosocomial outbreak of COVID-19 between 1st September and 15th November 2020, occurring in a setting without vaccination for any healthcare workers or patients. Methods Outbreak report and retrospective, matched case–control study using incidence density sampling in three cardiac wards in an 1100-bed tertiary teaching hospital in Calgary, Alberta, Canada. Patients were confirmed/probable COVID-19 cases and contemporaneous control patients without COVID-19. COVID-19 outbreak definitions were based on Public Health guidelines. Clinical and environmental specimens were tested by RT-PCR and as applicable quantitative viral cultures and whole genome sequencing were conducted. Controls were inpatients on the cardiac wards during the study period confirmed to be without COVID-19, matched to outbreak cases by time of symptom onset dates, age within ± 15 years and were admitted in hospital for at least 2 days. Demographics, Braden Score, baseline medications, laboratory measures, co-morbidities, and hospitalization characteristics were collected on cases and controls. Univariate and multivariate conditional logistical regression was used to identify independent risk factors for nosocomial COVID-19. Results The outbreak involved 42 healthcare workers and 39 patients. The strongest independent risk factor for nosocomial COVID-19 (IRR 3.21, 95% CI 1.47–7.02) was exposure in a multi-bedded room. Of 45 strains successfully sequenced, 44 (97.8%) were B.1.128 and differed from the most common circulating community lineages. SARS-CoV-2 positive cultures were detected in 56.7% (34/60) of clinical and environmental specimens. The multidisciplinary outbreak team observed eleven contributing events to transmission during the outbreak. Conclusions Transmission routes of SARS-CoV-2 in hospital outbreaks are complex; however multi-bedded rooms play a significant role in the transmission of SARS-CoV-2.
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    Understanding Movement Strategies in Adults Post Sternotomy: A Scoping Review Protocol
    (2022-11-13) Wiens, Karen; Hayden, K. Alix; King-Shier, Kathryn
    Objective: This scoping review will identify, map, and synthesize the available evidence for movement strategies in adults post sternotomy within the first 12 weeks postoperatively. Introduction: It is essential to identify safe movement strategies for adults post sternotomy that supports a safe, independent return to daily activity. In addition, there needs to be an evidence-informed approach to guide clinical practice that balances sternal healing while supporting proper movement strategies for the individual. A review of the evidence within this field is warranted to guide healthcare professionals in best practice as novel movement strategies have emerged. Inclusion criteria: This scoping review will include published, peer-reviewed studies (experimental, non-experimental, and qualitative) focusing on upper body movement strategies to resume activity post sternotomy within the first 12 weeks postoperatively. Systematic, descriptive, and narrative reviews that meet the inclusion criteria will also be considered. Additionally, case reports that focus on this topic will be included. Methods: The electronic databases to be searched include MEDLINE, Embase, CINAHL, PEDro, Sport Discus, Scopus, and the Cochrane Library. The search will be restricted to studies in English, with no date limit. Two independent reviewers will assess titles, abstracts, and full-text articles against the inclusion criteria. The reviewers will develop a data extraction tool; one reviewer will complete the data extraction, which the second reviewer will verify. The results of the data analysis will be presented in tabular and narrative form.