Background: The global outbreak of coronavirus disease (COVID-19) has caused unprecedented physical and mental stress among healthcare workers. This study clarified the stress states and associated factors among nurses who provided direct care to patients during the early stages of the COVID-19 pandemic.

Methods: To assess symptoms caused by traumatic and post-traumatic stress and related factors, a questionnaire survey consisting of the Impact of Event Scale-Revised (IES-R) was conducted on 400 nurses at 10 medical facilities (2 university hospitals, 4 designated medical institutions for infectious diseases, and 4 city hospitals) near Kurume city, Fukuoka Prefecture, that admitted patients with COVID-19 from September to October 2020.

Results: Responses were received from 289 nurses (72.3%), and 152 nurses who provided direct care to patients and answered all items (valid response rate: 52.6%) were subjected to analysis. The results identified 31 nurses (20.4%) as high risk of developing post-traumatic stress disorder (PTSD). Four items were found to be significantly associated with IES-R scores: "type of medical institution," "time to collect information for COVID-19," "number of nursing patients," and "duration of nursing care." Stepwise multivariate regression analysis and stepwise binomial logistic analysis showed that time spent collecting information on COVID-19 and the number of patients under nursing care were factors independently associated with IES-R scores and high risk of PTSD. In addition, these factors were suggested as being associated with nurses' physical and mental stress in the early stages of the COVID-19 pandemic.

Conclusion: To reduce stress among nurses in the early stages of an emerging or re-emerging infectious disease pandemic, it is important to establish a staff and work system that considers the number of patients and collects and disseminates information quickly and accurately.

The purpose of this survey was to examine the occurrence of secondary infections among roommates and the contributing factors when a patient with COVID-19 is placed in a multi-bed room. We conducted a statistical analysis of the relationship between the background characteristics of the roommates of patients with COVID-19 in a cluster that occurred at our hospital from August 2021 to September 2022 and the development of positive cases.

A total of 74 patients were eligible for the study, of whom 23 (31.1%) were tested positive. The median age was 70 years, with 53 males (71.6%) and 21 females (28.4%). Among those who tested positive, 20 were male (37.7%) and 3 were female (14.3%), suggesting a trend toward a higher positivity rate among males (p = 0.057). There were no differences between the positive and nonpositive groups in terms of the main disease, diabetes/HbA1c ≥ 6.5, steroid use, immunosuppressant/anticancer drug use, dialysis, or bed position.

The positive group had a significantly longer duration of shared occupancy with the index patient. Prompt testing at the onset of symptoms and early isolation of patients in the same room as positive cases may reduce the risk of infection in multi-bed rooms.

Hand hygiene is an important measure to prevent infection spread. During the COVID-19 pandemic, the spread of infection was reported in elderly care facilities. Because hand hygiene education is essential for improving hand hygiene compliance, this study verified the effectiveness of education specific to nursing care staff. From August to September 2022, we provided education using the ARCS model, a method for motivating learning, to nursing care staff at four elderly care facilities in northern Kanto, and compared the results of knowledge confirmation surveys before and after the education with hand hygiene compliance rates. The score on the knowledge check survey was 15.0±2.6 points before the training, and 18.8±1.0 points after training, indicating a significant increase in the score after the training (p < 0.001). There was no difference in hand hygiene compliance before contact with residents or before clean/sterile procedures, before and after the training. However, compliance rates increased after the risk of exposure to body fluids, contact with residents, touching objects around residents, and after using gloves following the training. The training programme, which incorporated educational theory, showed the potential to have an educational effect regardless of the participants' educational background, years of experience, or other attributes. The importance of education helped staff to recognize the necessity of washing hands before touching residents or performing clean/sterile operations.

Toys are used to observe the growth and developmental status of the babies and infants during health examination conducted by municipalities. In the waiting rooms during the health examination, children can play with the toys. Since the COVID-19 pandemic, stricter disinfection has been required to prevent infection in health examinations. The purpose of this study was to clarify the status of bacterial contamination of toys used in actual babies and infant health examinations and examine more effective disinfection methods for each toy material.

During the health examination in Town A, plastic, wooden, and cloth toys were distributed among 3-year-old participants, 1-year-old and 6-month-old to 2-year-old participants, and infants, respectively. After the health examination, the toys were collected and disinfected using ethanol, sodium hypochlorite, and various cleaning methods suitable for toys. Samples were collected and cultured according to the shape and characteristics of the toy material. The number of bacteria was calculated by counting the number of colonies. The number of bacteria before and after disinfection was compared to determine the rate of reduction. The rate of bacterial reduction was performed using Kruskal-Wallis test, and if significant differences were observed, multiple comparisons were performed. In addition, those with a bacterial reduction rate of 90% or more were considered successful sterilization, and an effective disinfection method was determined.

Regarding the disinfection effect, plastic toys were effectively disinfected with ethanol and sodium hypochlorite wipes. For wooden toys, ethanol wiping, sodium hypochlorite wiping, and detergent washing were particularly effective, and for cloth toys, ethanol soaking, sodium hypochlorite soaking, and detergent washing were highly effective.

Hand hygiene is an important component in the prevention of healthcare-associated infections, for which alcohol-based hand sanitizers (ABHRs) are frequently used. However, skin dryness and hand irritation caused by ABHRs may interfere with hand hygiene. Herein, skin water evaporation and skin moisture content were measured in healthy Japanese men and women between 20 and 59 years of age to evaluate the moisturizing effects of three foaming ABHRs available in Japan. Agent A (72 vol% ethanol) showed the highest moisturizing effect in terms of skin moisture content and retained more moisture than Agents B and C (76.9-81.4 vol% ethanol). This suggested that Agent A, which has a lower ethanol concentration, may be superior for skin moisture retention. The results of this study suggest that ABHR choice in hand hygiene practice in healthcare settings can help prevent hand dryness and promote compliance with hand hygiene. To reduce the risk of hand irritation from repeated hand hygiene, healthcare workers must comprehensively evaluate ABHR selection, considering factors such as moisturizing effects and overall user experience.