Staff risks stratification in preparation for COVID-19 in a tertiary healthcare facility in Nigeria

Abstract

Introduction: this report is a documentation of a staff risk stratification programme, undertaken in University of Benin Teaching Hospital, with outcomes, and the actions taken to protect staff. Methods: an adapted risk stratification tool was circulated to all staff through their respective heads of departments/units. Staff were expected to voluntary assess their health and risk status in the context of COVID-19, using the tool. A central multi-disciplinary screening committee assessed submissions and invited staff who required further evaluation for physical interviews. Respondents were categorized into three risk/exposure groups from lowest to highest - A, B, and C, based on their individual health assessments, occupational exposures, and information obtained from direct interviews. Results: the committee received submissions from 746 staff, representing 19.4% (about a fifth) of the hospital’s 3,840 staff. One hundred and twenty two of these were invited for physical interviews, of whom 88 (72.1%) were categorized as high risk (Category C): pregnancy (53.4%); bronchial asthma (19.3%); hypertension (11.4%); cancer (3.4%) and sickle cell disease (2.3%); fractures and pulmonary tuberculosis (1%, respectively). These staff were recommended for redeployment from areas of high risk exposure to COVID-19. Conclusion: a management-driven risk assessment of hospital staff in preparation for the COVID-19 pandemic revealed that a fifth of staff assessed themselves as being vulnerable to adverse outcomes from exposure. It is our hope that similar risk stratification programmes will become standard practice in healthcare facilities during disease outbreaks, especially in Africa.

Facility-Based Surveillance Activities for COVID-19 Infection and Outcomes among Healthcare Workers in a Nigerian Tertiary Hospital

“…This 860-bed facility renders promotive, preventive, curative, and rehabilitative services in various departments, including internal medicine, surgery, pediatrics, mental health, community health, obstetrics and gynecology, radiology, ear, nose and throat, anesthesiology, ophthalmology, family medicine, and dentistry. 22,23 The UBTH currently has a staff strength of 4,220.…”

“…A risk stratification tool was adapted to identify vulnerable staff who were re-deployed to nonclinical areas or asked to work from home. 23 In addition to increasing the purchase and availability of face masks, gloves, and eye goggles (necessary for standard precautions and transmission based precautions), relevant hospital departments embarked on the local production of plastic aprons, coveralls, and face shields. Also, information education and communication posters on COVID-19 were placed at strategic locations, and advisories were regularly communicated to staff.…”

COVID-19 pandemic: an assessment of the risk perception and practice of precautionary measures amongst a group of primary care workers in Nigeria

“…A study on staff risk stratification in UBTH found that core clinical staff such as doctors and nurses made up over 75% of workers in the high-risk category [ 29 ]. In the present study however, pharmacists had the highest odds of having high risk perception (OR: 5.4; 95% CI = 1.776-6.450).…”

Coping with the Third wave of the COVID-19 Pandemic in Africa: Implications for an Improved Outbreak Response

“…To ensure adherence to recommended IPC measures, individual health facilities are required to conduct COVID-19 risk assessment across all the departments to rank the risks of exposure [ 17 ]. Ranking of risks will help to identify high-risk departments, such as the emergency department, to inform on the need to scale up the provision of IPC equipment and materials in such departments.…”