A bstract Background The COVID-19 pandemic had a massive impact on healthcare systems, increasing the risks of psychological distress in health professionals. Burnout is a prolonged response to chronic emotional and interpersonal stressors on the job and is defined by the three dimensions of emotional exhaustion, cynicism, and personal inefficacy. Methodology A cross-sectional descriptive design was used to assess the burnout and resilience among frontline nurses in the emergency department of a tertiary care center in North India during COVID-19 pandemic. The sample consisted of 120 frontline nurses working in the emergency department, selected by a simple random sampling method. Data were collected using the Maslach burnout inventory-general survey and the Connor–Davidson Resilience Scale. Results The nurses in the emergency during pandemic experienced a moderate-to-severe level of burnout in emotional exhaustion (29.13 ± 10.30) and depersonalization (12.90 ± 4.67) but mild-to-moderate level of burnout in reduced personal accomplishment (37.68 ± 5.17) and showed a moderate to a high level of resilience (77.77 ± 12.41). The two metrics of burnout viz ., emotional exhaustion and personal inefficacy had a significantly negative correlation with resilience among the frontline nurses in the emergency ( r = 0.25, p < 0.05 and r = 0.31, p < 0.01, respectively). A significant negative correlation has been identified between burnout and resilience that informs the role of resilience in alleviating burnout during this pandemic. Conclusion Effective interventions for improving resilience are needed to relieve nurses’ burnout and workplace stressors. Also, the administration should ensure a healthy workplace and adopt a positive attitude and harmonious relationship with the frontline workers in the mitigation of the pandemic. How to cite this article Jose S, Dhandapani M, Cyriac MC. Burnout and Resilience among Frontline Nurses during COVID-19 Pandemic: A Cross-sectional Study in the Emergency Department of a Tertiary Care Center, North India. Indian J Crit Care Med 2020;24(11):1081–1088.

A bstract Background In the event of coronavirus disease-2019 (COVID-19) spread worldwide, frontline healthcare workers play a key role in the containment of this devastating pandemic, and to prevent the cross-transmission and gain confidence in battle with the pandemic, they are wearing personal protective equipment (PPE). Aim and objective To explore the adverse health problems and skin reactions caused by the use of PPEs among the frontline nurses in the ICUs of COVID hospital. Materials and methods A cross-sectional study was conducted using an online-based questionnaire assessing the physical problems, and adverse skin reactions of PPEs were sent among the 150 frontline nurses in ICUs of COVID hospital. The collected data were analyzed using descriptive statistics. Results We got 137 valid responses from frontline nurses, and the most common adverse health effects expressed by them were headache (73.4%), extreme sweating (59.6%), and difficulty in breathing (36.7%); 91.7% complained about the fogging of the goggle. Majority of frontline nurses expressed nasal bridge scarring (76.64%) and indentation and pain on the back of the ears (66.42%) as the adverse skin reactions after wearing N95 masks. The common skin problems identified due to double gloving of latex gloves were excessive skin soakage with sweat (70.07%) and skin chapping (19%). The protective clothing caused minimal adverse reactions, and excessive sweating (71.53%) was the most reported. Conclusion The healthcare workers wearing PPE for a prolonged period show significant adverse effects, so appropriate strategies should be taken to prevent the adverse effects by designing effective PPEs and education of preventive measures among healthcare workers. How to cite this article Jose S, Cyriac MC, Dhandapani M. Health Problems and Skin Damages Caused by Personal Protective Equipment: Experience of Frontline Nurses Caring for Critical COVID-19 Patients in Intensive Care Units. Health Problems and Skin Damages Caused by Personal Protective Equipment: Experience of Frontline Nurses Caring for Critical COVID-19 Patients in Intensive Care Units. Indian J Crit Care Med 2021;25(2):134–139.

Early nutritional supplementation and monitoring of haemoglobin should be an important part of nursing care interventions for patients at increased risk of developing pressure ulcer.

Background Workplace violence (WPV) includes verbal abuse, physical violence, bullying or mobbing, assault and sexual harassment. The area has been well researched in the developed and high‐income countries among nurses and healthcare professionals, but in the case of the low and upper‐middle‐income countries, there remains a paucity of comprehensive data on the prevalence of WPV and its contributing factors. Aims To estimate the prevalence and determinants of WPV among nurses working in the South‐East Asian Region and Western Pacific Regions. Design Systematic review and Meta‐analysis. Method A comprehensive search was done to retrieve articles based on a PRISMA compliant protocol registered in PROSPERO: CRD 42020223605. Study selection, quality assessment and data abstraction were independently done by the team members and discrepancies addressed through mutual consensus. Random‐effect meta‐analysis, I2 statistics and subgroup analysis were done. Results The review included 41 studies conducted among 42,222 nurses from 13 countries. The pooled prevalence of WPV, verbal abuse, physical violence, threatening behaviour, physical assault, sexual harassment and bullying/mobbing were 58% (CI 51%‐64%), 64% (CI 59%‐70%), 23% (CI 14%–34%), 30(CI‐11%–52%), 21% (CI 8%‐38%), 12% (CI 7%‐17%) and 25% (17%‐33%), respectively. The various determinants of WPV included attributes related to the patient, nurses and organisation. Moreover, the impact of WPV included physical, psychological repercussions on nurses and the various measures used to manage it. Conclusion Nurses encounter a high level of WPV especially verbal abuse in their workplace settings. Nursing councils and professional nursing organisations should put in their effort towards the formulation and implementation of occupational safety legislation in their respective countries through appropriate political lobbying. Relevance to clinical practice. Our review highlights the emerging need to focus on the prevention of WPV among nurses working in lower, middle and upper‐middle‐income countries. Legislation changes and organisational commitment are vital for ensuring effective policies to combat WPV.

Objective To assess willingness for the coronavirus disease 2019 (COVID-19) vaccine and identify the factors attributing to the willingness. Design A cross-sectional study was conducted, adopting an exponential, non-discriminative snowball sampling technique. The questionnaire collected the socio-demographic profile, history of COVID-19 infection, presence of co-morbidities (diabetes mellitus, hypertension, chronic obstructive pulmonary disease (COPD), asthma, cancer), willingness, and preference of vaccine among participants. An online platform (Google Forms) was used to collect data from all over India. A total of 2032 Indian adults aged above 18 years were included in the study. Results Around 1598 (78.6%) expressed willingness to receive the COVID vaccine, and among the healthcare providers (HCPs), 579 (80.3%) were willing for COVID vaccination. Factors like the belief that the vaccine is necessary (aOR=1.68, 95% CI =1.34 to 2.11), respondents having no history of COVID infection (aOR=0.71, 95% CI: 0.52 to 0.97), having trust in the government (aOR=6.09, CI: 4.59 to 7.98), people who felt the cost of the vaccine didn’t matter (aOR=4.92, CI: 3.80 to 6.37), and respondents with no perceived risk of COVID infection (aOR=0.63; CI: 0.47 to 0.83) were more associated with willingness for COVID vaccination. Conclusions An effective vaccine should be well-received by the public. The responsibility lies with the government, health authorities, and manufacturers to take appropriate steps to dispel rumors in order to ensure people’s understanding and acceptance.