420. Emergency Nurses’ Experiences over 1 Year of the COVID-19 Pandemic: A Qualitative Study

Abstract Background At the frontline of fighting against the coronavirus disease 2019 (COVID-19) pandemic, emergency room (ER) nurses are faced with various challenges throughout the provision of emergency care for incoming patients without knowing their COVID-19 status. However, little is known about their work burden, exhaustion, and psychological distress in the pandemic. Therefore, to provide basic data for effective counterstrategies against future emerging infectious diseases in the ER, this study aims to understand ER nurses’ COVID-19 work experiences in depth at one tertiary hospital over 1 year. Table 1. Summary of Qualitative Responses Regarding Emergency Room Nurses’ COVID-19 Pandemic Experience Methods This study was conducted at a 2,715-bed tertiary hospital in Seoul, Korea. Using a purposeful sampling method, we recruited 20 nurses who have worked for more than 1 year in the ER and have capacity for independent care for COVID-19 patients. With institutional review board approval, one-on-one individual, in-depth interviews were completed using a semi-structured questionnaire from February 13 to March 25, 2021. After recording and transcribing interviews, the narrative data were analyzed using a thematic analysis method. Results The 20 participants were 29.9 years old on average with 69.2 months’ clinical experience. The overarching theme was derived as ‘COVID-19 highlighted the importance of ER’s infection control and ER nurses’ professional dedication’ covering 6 sub-themes and 16 concepts (Table 1). Sub-themes were ‘psychological burden of handling COVID-19 patients directly’, ‘unprecedented changes for ER’s response to the pandemic’, ‘revealing hospital’s lack of support for ER’, ‘withdrawal from social life as ER nurses’, ‘re-illuminating nurses’ calling for their occupation’, and ‘planning for the post COVID-19 era’. Conclusion ER nurses experienced challenges from their drastically changed tasks, received poor compensation from the hospital, and felt pressure from social expectations towards medical personnel. However, nurses showed enough dedication towards their jobs, considered pandemic experience as a valuable asset to their future career, and maintained a positive attitude towards difficulties in ER. Providing comprehensive support for ER nurses is necessary to improve ER infection control to respond to the pandemic. Disclosures All Authors: No reported disclosures


Conclusion.
A low prevalence of detectable SC2 RNA was observed among staff area high-touch surfaces; however, the likelihood of detection increased over time. Environmental SC2 RNA detection may reflect primary contamination from infected healthcare workers or secondary contamination from contact with infected patients, though a direct relationship between surface SC2 RNA viral detection and transmission risk has not been established.
Disclosures Background. At the frontline of fighting against the coronavirus disease 2019 (COVID-19) pandemic, emergency room (ER) nurses are faced with various challenges throughout the provision of emergency care for incoming patients without knowing their COVID-19 status. However, little is known about their work burden, exhaustion, and psychological distress in the pandemic. Therefore, to provide basic data for effective counterstrategies against future emerging infectious diseases in the ER, this study aims to understand ER nurses' COVID-19 work experiences in depth at one tertiary hospital over 1 year. Methods. This study was conducted at a 2,715-bed tertiary hospital in Seoul, Korea. Using a purposeful sampling method, we recruited 20 nurses who have worked for more than 1 year in the ER and have capacity for independent care for COVID-19 patients. With institutional review board approval, one-on-one individual, in-depth interviews were completed using a semi-structured questionnaire from February 13 to March 25, 2021. After recording and transcribing interviews, the narrative data were analyzed using a thematic analysis method.
Results. The 20 participants were 29.9 years old on average with 69.2 months' clinical experience. The overarching theme was derived as 'COVID-19 highlighted the importance of ER's infection control and ER nurses' professional dedication' covering 6 sub-themes and 16 concepts (Table 1). Sub-themes were 'psychological burden of handling COVID-19 patients directly' , 'unprecedented changes for ER's response to the pandemic' , 'revealing hospital's lack of support for ER' , 'withdrawal from social life as ER nurses' , 're-illuminating nurses' calling for their occupation' , and 'planning for the post COVID-19 era' .
Conclusion. ER nurses experienced challenges from their drastically changed tasks, received poor compensation from the hospital, and felt pressure from social expectations towards medical personnel. However, nurses showed enough dedication towards their jobs, considered pandemic experience as a valuable asset to their future career, and maintained a positive attitude towards difficulties in ER. Providing comprehensive support for ER nurses is necessary to improve ER infection control to respond to the pandemic.
Disclosures. All Authors: No reported disclosures

Effect of SARs-Cov-2 mRNA Vaccination in Healthcare Workers with Household COVID Exposure
Laura Selby, DO 1 ; Richard Starlin, MD 1 ; 1 University of Nebraska Medicine, Omaha, Nebraska

Session: P-19. COVID-19 Infection Prevention
Background. Healthcare workers have experienced a significant burden of COVID-19 disease. COVID mRNA vaccines have shown great efficacy in prevention of severe disease and hospitalization due to COVID infection, but limited data is available about acquisition of infection and asymptomatic viral shedding.
Methods. Fully vaccinated healthcare workers at a tertiary-care academic medical center in Omaha Nebraska who reported a household exposure to COVID-19 infection are eligible for a screening program in which they are serially screened with PCR but allowed to work if negative on initial test and asymptomatic. Serial screening by NP swab was completed every 5-7 days, and workers became excluded from work if testing was positive or became symptomatic.
Results. Of the 94 employees who were fully vaccinated at the time of the household exposure to COVID-19 infection, 78 completed serial testing and were negative. Sixteen were positive on initial or subsequent screening. Vaccine failure rate of 17.0% (16/94). Healthcare workers exposed to household COVID positive contact

Conclusion.
High risk household exposures to COVID-19 infection remains a significant potential source of infections in healthcare workers even after workers are fully vaccinated with COVID mRNA vaccines especially those with contact to positive domestic partners.
Disclosures. Background. Hand hygiene (HH) is a standard infection prevention and control precaution to be applied in healthcare settings to prevent transmission of COVID-19. Many healthcare institutions observed significant improvements in HH performance during wave one of the COVID-19 pandemic but the sustainability of this change is unknown. Our aim was to evaluate long-term HH performance throughout subsequent waves of the pandemic across acute care hospitals in Ontario, Canada.
Methods. HH adherence was measured using a previously validated group electronic monitoring system which was installed on all alcohol handrub and sink soap dispensers inside and outside each patient room across 56 inpatient units (35 wards and 21 critical care units) spanning 13 acute care hospitals (6 university and 7 community teaching hospitals) from 1 November 2019 to 31 May 2021. Daily HH adherence was compared with daily COVID-19 case count across Ontario. During this period, weekly performance continued to be reported to units but unit-based quality improvement discussions were inconsistent due to the COVID-19 response.
Results. Figure 1 depicts daily aggregate HH adherence plotted against the new daily COVID-19 case count across Ontario. An elevation in HH adherence was seen prior to the start of the first wave, rising almost to 80% and then remained above 70% for the peak of wave one. During waves two and three, peak COVID-19 case counts were associated with a maximum HH adherence of 51%, only marginally above the pre-pandemic baseline. After the end of wave one (from 1 July 2020 to 31 May 2021) the median HH performance was only 49% (interquartile range 47%-50%).