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Okyere Boadu R, Okyere Boadu KA, Kumasenu Mensah N, Adzakpah G, Afaglo F, Bermaa Abrefa R, Aryee E, Gyamena Botwe N, Baiden-Amissah D, Bless Ashiavor D, Lee Mensah L, Kojo Asamoah L, Obiri-Yeboah J. Healthcare Providers' Adherence to COVID-19 Prevention and Control Practices in Health Records and Information Management, Ghana. Glob Health Epidemiol Genom 2024; 2024:8862660. [PMID: 39006150 PMCID: PMC11245336 DOI: 10.1155/2024/8862660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 06/13/2024] [Accepted: 06/15/2024] [Indexed: 07/16/2024] Open
Abstract
Background The impact of contracting coronavirus on healthcare providers (HCPs) affects their ability to combat the infection. The virus can be transmitted through droplets from sneezing, coughing, and yelling, making it essential for HCPs to plan ahead when dealing with patients with respiratory symptoms. The need to assess healthcare providers' perceived adherence to COVID-19 Prevention and Control Practices (PCP) in Health Records and Information Management is vital for optimizing healthcare operations and ensuring the safety of both patients and providers. This study assesses healthcare providers' perceived adherence to COVID-19 PCP in Health Records and Information Management. Subjects and Method. A cross-sectional survey was conducted to collect data from 1268 HCPs working in eight randomly selected hospitals across five regions in Ghana. The survey was carried out from May 15, 2022, to August 13, 2022. Simple random sampling was used to choose these eight facilities from a total of 204 hospitals. Within each facility, HCPs from various departments were selected using simple random sampling. The EpiInfo 7 software's StatCalc tool was used to choose a total sample size of 1268 from an estimated 4482 HCP-PR from the eight hospitals. Compliance with COVID-19 PCP was assessed using a 3-point scale, ranging from one (Yes always) to three (No). Cronbach's alpha reliability coefficient was used to examine the statistical reliability of the variables in the dataset. Cronbach's alpha was 0.73 overall, suggesting strong reliability. Bartlett's test for equal variances was used for comparative analysis of health facility and overall mean COVID-19 PCP in different areas of health facilities. IBM SPSS (version 23) statistical software was used for the data analysis process. Results A total of 1268 HCP-PR participated in the survey, resulting in a 99.6% response rate. Findings reveal that 760 healthcare professionals who handle patients' records (HCP-PR), constituting 60%, consistently followed COVID-19 protocols in the registration and clinic preparation zones. Another 390 individuals (30.7%) adhered to these protocols occasionally, while 119 (9.4%) failed to comply. Similarly, in the filing area, 739 respondents (58.3%) consistently adhered to COVID-19 protocols, 358 (28.3%) occasionally did so, and 170 (13.4%) did not follow the protocols at all. Regarding handling health records cautiously, 540 participants (42.5%) always did, 448 (35.3%) did so sometimes, and 280 (22.2%) neglected these precautions. Additionally, 520 respondents (41.0%) consistently followed COVID-19 precautions when handling computers and other equipment, 393 (31.0%) did so occasionally, and 355 (28.0%) did not adhere to these precautions. Conclusion The majority of respondents showed good compliance with COVID-19 protocol in the registration and clinic preparation areas. However, in the filing area, just over four out of every seven respondents consistently adhered to COVID-19 PCP. Additionally, four out of every seven participants did not comply with COVID-19 PCP when handling patients' records. Analysis reveals diverse adherence to COVID-19 PCP, and statistical tests show variable performance, highlighting standout health facilities.
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Affiliation(s)
- Richard Okyere Boadu
- Department of Health Information Management School of Allied Health SciencesCollege of Health and Allied Health SciencesUniversity of Cape Coast, Cape Coast, Ghana
| | - Kwame Adu Okyere Boadu
- School of Medicine and DentistryCollege of Health SciencesKwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Nathan Kumasenu Mensah
- Department of Health Information Management School of Allied Health SciencesCollege of Health and Allied Health SciencesUniversity of Cape Coast, Cape Coast, Ghana
| | - Godwin Adzakpah
- Department of Health Information Management School of Allied Health SciencesCollege of Health and Allied Health SciencesUniversity of Cape Coast, Cape Coast, Ghana
| | - Fortune Afaglo
- Department of Health Information Management School of Allied Health SciencesCollege of Health and Allied Health SciencesUniversity of Cape Coast, Cape Coast, Ghana
| | - Rosemary Bermaa Abrefa
- Department of Health Information Management School of Allied Health SciencesCollege of Health and Allied Health SciencesUniversity of Cape Coast, Cape Coast, Ghana
| | - Emmanuella Aryee
- Department of Health Information Management School of Allied Health SciencesCollege of Health and Allied Health SciencesUniversity of Cape Coast, Cape Coast, Ghana
| | - Nancy Gyamena Botwe
- Department of Health Information Management School of Allied Health SciencesCollege of Health and Allied Health SciencesUniversity of Cape Coast, Cape Coast, Ghana
| | - Dinah Baiden-Amissah
- Department of Health Information Management School of Allied Health SciencesCollege of Health and Allied Health SciencesUniversity of Cape Coast, Cape Coast, Ghana
| | - Dennis Bless Ashiavor
- Department of Health Information Management School of Allied Health SciencesCollege of Health and Allied Health SciencesUniversity of Cape Coast, Cape Coast, Ghana
| | - Larry Lee Mensah
- Department of Health Information Management School of Allied Health SciencesCollege of Health and Allied Health SciencesUniversity of Cape Coast, Cape Coast, Ghana
| | - Lovemond Kojo Asamoah
- Department of Health Information Management School of Allied Health SciencesCollege of Health and Allied Health SciencesUniversity of Cape Coast, Cape Coast, Ghana
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Banafshi Z, Valiee S, Moradi Y, Vatandost S. The Relationship Between Attitude, Belief, Experience, and Knowledge of Iranian Nurses Toward the Use of Personal Protective Equipment: A Cross-Sectional Study. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2024; 29:466-472. [PMID: 39205844 PMCID: PMC11349161 DOI: 10.4103/ijnmr.ijnmr_238_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 03/17/2024] [Accepted: 03/18/2024] [Indexed: 09/04/2024]
Abstract
Background Utilizing Personal Protective Equipment (PPE) is pivotal in averting infection transmission to both patients and nurses. The attitude of nurses is a critical determinant in their compliance with PPE usage. This study seeks to explore the correlation between the attitudes of Iranian nurses and their beliefs, experiences, and knowledge concerning the application of PPE. Materials and Methods In this cross-sectional study, 303 nurses employed in hospitals affiliated with Kurdistan University of Medical Sciences (Iran) were chosen using a quota sampling technique. Between April and June 2022, they completed self-administered questionnaires, which consisted of a Demographic Information form and a four-part questionnaire on "Attitude, Belief, Experience, Knowledge" concerning the utilization of PPE. Data were analyzed utilizing descriptive and inferential statistical methods. The multiple linear regression model was applied to investigate the relationship between attitude scores and various examined variables. Results The findings indicated that most participants held bachelor's degrees (93.07%), and their attitude scores toward using PPE exceeded 3.25 out of 6 for all 12 questions. Female gender, increased work experience, and higher organizational positions exhibited positive and significant associations with a favorable attitude toward PPE utilization. Conversely, the absence of training related to PPE, a lack of belief in infection control, and limited knowledge displayed negative correlations. Conclusions Nurses have an ethical obligation to adhere to infection control guidelines, including consistently utilizing PPE, regardless of the level of infection risk or the visibility of the infection. Continuous training and regular monitoring of nurses in this context are indispensable.
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Affiliation(s)
- Zhina Banafshi
- Students Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Sina Valiee
- Clinical Care Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Yousef Moradi
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Salam Vatandost
- Clinical Care Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
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Constantin AM, Noertjojo K, Sommer I, Pizarro AB, Persad E, Durao S, Nussbaumer-Streit B, McElvenny DM, Rhodes S, Martin C, Sampson O, Jørgensen KJ, Bruschettini M. Workplace interventions to reduce the risk of SARS-CoV-2 infection outside of healthcare settings. Cochrane Database Syst Rev 2024; 4:CD015112. [PMID: 38597249 PMCID: PMC11005086 DOI: 10.1002/14651858.cd015112.pub3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
BACKGROUND Although many people infected with SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) experience no or mild symptoms, some individuals can develop severe illness and may die, particularly older people and those with underlying medical problems. Providing evidence-based interventions to prevent SARS-CoV-2 infection has become more urgent with the potential psychological toll imposed by the coronavirus disease 2019 (COVID-19) pandemic. Controlling exposures to occupational hazards is the fundamental method of protecting workers. When it comes to the transmission of viruses, workplaces should first consider control measures that can potentially have the most significant impact. According to the hierarchy of controls, one should first consider elimination (and substitution), then engineering controls, administrative controls, and lastly, personal protective equipment. This is the first update of a Cochrane review published 6 May 2022, with one new study added. OBJECTIVES To assess the benefits and harms of interventions in non-healthcare-related workplaces aimed at reducing the risk of SARS-CoV-2 infection compared to other interventions or no intervention. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, Web of Science Core Collections, Cochrane COVID-19 Study Register, World Health Organization (WHO) COVID-19 Global literature on coronavirus disease, ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform, and medRxiv to 13 April 2023. SELECTION CRITERIA We included randomised controlled trials (RCTs) and non-randomised studies of interventions. We included adult workers, both those who come into close contact with clients or customers (e.g. public-facing employees, such as cashiers or taxi drivers), and those who do not, but who could be infected by coworkers. We excluded studies involving healthcare workers. We included any intervention to prevent or reduce workers' exposure to SARS-CoV-2 in the workplace, defining categories of intervention according to the hierarchy of hazard controls (i.e. elimination; engineering controls; administrative controls; personal protective equipment). DATA COLLECTION AND ANALYSIS We used standard Cochrane methods. Our primary outcomes were incidence rate of SARS-CoV-2 infection (or other respiratory viruses), SARS-CoV-2-related mortality, adverse events, and absenteeism from work. Our secondary outcomes were all-cause mortality, quality of life, hospitalisation, and uptake, acceptability, or adherence to strategies. We used the Cochrane RoB 2 tool to assess risk of bias, and GRADE methods to evaluate the certainty of evidence for each outcome. MAIN RESULTS We identified 2 studies including a total of 16,014 participants. Elimination-of-exposure interventions We included one study examining an intervention that focused on elimination of hazards, which was an open-label, cluster-randomised, non-inferiority trial, conducted in England in 2021. The study compared standard 10-day self-isolation after contact with an infected person to a new strategy of daily rapid antigen testing and staying at work if the test is negative (test-based attendance). The trialists hypothesised that this would lead to a similar rate of infections, but lower COVID-related absence. Staff (N = 11,798) working at 76 schools were assigned to standard isolation, and staff (N = 12,229) working at 86 schools were assigned to the test-based attendance strategy. The results between test-based attendance and standard 10-day self-isolation were inconclusive for the rate of symptomatic polymerase chain reaction (PCR)-positive SARS-CoV-2 infection (rate ratio (RR) 1.28, 95% confidence interval (CI) 0.74 to 2.21; 1 study; very low-certainty evidence). The results between test-based attendance and standard 10-day self-isolation were inconclusive for the rate of any PCR-positive SARS-CoV-2 infection (RR 1.35, 95% CI 0.82 to 2.21; 1 study; very low-certainty evidence). COVID-related absenteeism rates were 3704 absence days in 566,502 days-at-risk (6.5 per 1000 working days) in the control group and 2932 per 539,805 days-at-risk (5.4 per 1000 working days) in the intervention group (RR 0.83, 95% CI 0.55 to 1.25). We downgraded the certainty of the evidence to low due to imprecision. Uptake of the intervention was 71% in the intervention group, but not reported for the control intervention. The trial did not measure our other outcomes of SARS-CoV-2-related mortality, adverse events, all-cause mortality, quality of life, or hospitalisation. We found seven ongoing studies using elimination-of-hazard strategies, six RCTs and one non-randomised trial. Administrative control interventions We found one ongoing RCT that aims to evaluate the efficacy of the Bacillus Calmette-Guérin (BCG) vaccine in preventing COVID-19 infection and reducing disease severity. Combinations of eligible interventions We included one non-randomised study examining a combination of elimination of hazards, administrative controls, and personal protective equipment. The study was conducted in two large retail companies in Italy in 2020. The study compared a safety operating protocol, measurement of body temperature and oxygen saturation upon entry, and a SARS-CoV-2 test strategy with a minimum activity protocol. Both groups received protective equipment. All employees working at the companies during the study period were included: 1987 in the intervention company and 1798 in the control company. The study did not report an outcome of interest for this systematic review. Other intervention categories We did not find any studies in this category. AUTHORS' CONCLUSIONS We are uncertain whether a test-based attendance policy affects rates of PCR-positive SARS-CoV-2 infection (any infection; symptomatic infection) compared to standard 10-day self-isolation amongst school and college staff. A test-based attendance policy may result in little to no difference in absenteeism rates compared to standard 10-day self-isolation. The non-randomised study included in our updated search did not report any outcome of interest for this Cochrane review. As a large part of the population is exposed in the case of a pandemic, an apparently small relative effect that would not be worthwhile from the individual perspective may still affect many people, and thus become an important absolute effect from the enterprise or societal perspective. The included RCT did not report on any of our other primary outcomes (i.e. SARS-CoV-2-related mortality and adverse events). We identified no completed studies on any other interventions specified in this review; however, eight eligible studies are ongoing. More controlled studies are needed on testing and isolation strategies, and working from home, as these have important implications for work organisations.
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Affiliation(s)
- Alexandru Marian Constantin
- Department of Internal Medicine Clinical Hospital Colentina, University of Medicine and Pharmacy "Carol Davila", Bucharest, Romania
- Cochrane Austria, Department for Evidence-based Medicine and Evaluation, Danube University Krems, Krems, Austria
| | | | - Isolde Sommer
- Cochrane Austria, Department for Evidence-based Medicine and Evaluation, University for Continuing Education Krems, Krems, Austria
| | | | - Emma Persad
- Cochrane Austria, Department for Evidence-based Medicine and Evaluation, University for Continuing Education Krems, Krems, Austria
- Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Solange Durao
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Barbara Nussbaumer-Streit
- Cochrane Austria, Department for Evidence-based Medicine and Evaluation, University for Continuing Education Krems, Krems, Austria
| | - Damien M McElvenny
- Centre for Occupational and Environmental Health, University of Manchester, Manchester, UK
- Institute of Occupational Medicine, Edinburgh, UK
| | - Sarah Rhodes
- Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | | | | | - Karsten Juhl Jørgensen
- Centre for Evidence-Based Medicine Odense (CEBMO) and Cochrane Denmark, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Matteo Bruschettini
- Cochrane Sweden, Department of Research and Education, Lund University, Skåne University Hospital, Lund, Sweden
- Paediatrics, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden
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Batra N, Acharya S, Ahuja A, Saboo K. Guarding Health: A Comprehensive Review of Nosocomial Infections in Sickle Cell Anemia, a Multifaceted Approach to Prevention. Cureus 2024; 16:e53224. [PMID: 38425631 PMCID: PMC10902742 DOI: 10.7759/cureus.53224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 01/29/2024] [Indexed: 03/02/2024] Open
Abstract
This comprehensive review explores the complex dynamics of nosocomial infections in individuals with sickle cell anemia (SCA) and advocates for a collaborative strategy to enhance prevention. SCA patients, marked by compromised immunity and susceptibility to infections, face unique challenges that necessitate tailored preventive measures. The review underscores the importance of vaccination, antibiotic prophylaxis, education, and environmental hygiene in mitigating the risk of nosocomial infections. Addressing socioeconomic factors, healthcare system limitations, patient-related issues, and cultural considerations is imperative for effective prevention. The call to action emphasizes the pivotal roles of healthcare professionals, policymakers, researchers, and community engagement in implementing targeted interventions. By fostering a collective effort, this review envisions an improved landscape for infection prevention in SCA patients, enhancing their overall health outcomes and quality of life.
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Affiliation(s)
- Nitish Batra
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Sourya Acharya
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Abhinav Ahuja
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Keyur Saboo
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
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Plitman E, Kim E, Patel R, Kohout S, Jin R, Chan V, Dinsmore M. Development of an Automated and Scalable Virtual Assistant to Aid in PPE Adherence: A Study with Implications for Applications within Anesthesiology. J Med Syst 2023; 48:7. [PMID: 38157145 DOI: 10.1007/s10916-023-02028-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 12/14/2023] [Indexed: 01/03/2024]
Abstract
Virtual assistants (VAs) are conversational agents that are able to provide cognitive aid. We developed a VA device for donning and doffing personal protective equipment (PPE) procedures and compared it to live human coaching to explore the feasibility of using VAs in the anesthesiology setting. An automated, scalable, voice-enabled VA was built using the Amazon Alexa device and Alexa Skills application. The device utilized voice-recognition technology to allow a touch-free interactive user experience. Audio and video step-by-step instructions for proper donning and doffing of PPE were programmed and displayed on an Echo Show device. The effectiveness of VA in aiding adherence to PPE protocols was compared to traditional human coaching in a randomized, controlled, single-blinded crossover design. 70 anesthesiologists, anesthesia assistants, respiratory therapists, and operating room nurses performed both donning and doffing procedures, once under step-by-step VA instructional guidance and once with human coaching. Performance was assessed using objective performance evaluation donning and doffing checklists. More participants in the VA group correctly performed the step of "Wash hands for 20 seconds" during both donning and doffing tests. Fewer participants in the VA group correctly performed the steps of "Put cap on and ensure covers hair and ears" and "Tie gown on back and around neck". The mean doffing total score was higher in the VA group; however, the donning score was similar in both groups. Our study demonstrates that it is feasible to use commercially available technology to create a voice-enabled VA that provides effective step-by-step instructions to healthcare professionals.
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Affiliation(s)
- Eric Plitman
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Anesthesia and Pain Medicine, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada
| | - Edward Kim
- Department of Computer Sciences, Drexel University, Philadelphia, USA
| | - Rajesh Patel
- Department of Anesthesia and Pain Medicine, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada
| | - Seema Kohout
- Department of Anesthesia and Pain Medicine, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada
| | - Rongyu Jin
- Department of Anesthesia and Pain Medicine, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada
| | - Vincent Chan
- Department of Anesthesia and Pain Medicine, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada
| | - Michael Dinsmore
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
- Department of Anesthesia and Pain Medicine, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada.
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Berthelot S, Longtin Y, Margni M, Guertin JR, LeBlanc A, Marx T, Mangou K, Bluteau A, Mantovani D, Mikhaylin S, Bergeron F, Dancause V, Desjardins A, Lahrichi N, Martin D, Sossa CJ, Lachapelle P, Genest I, Schaal S, Gignac A, Tremblay S, Hufty É, Bélanger L, Beatty E. Postpandemic Evaluation of the Eco-Efficiency of Personal Protective Equipment Against COVID-19 in Emergency Departments: Proposal for a Mixed Methods Study. JMIR Res Protoc 2023; 12:e50682. [PMID: 38060296 PMCID: PMC10739239 DOI: 10.2196/50682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 07/21/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has had a profound impact on emergency department (ED) care in Canada and around the world. To prevent transmission of COVID-19, personal protective equipment (PPE) was required for all ED care providers in contact with suspected cases. With mass vaccination and improvements in several infection prevention components, our hypothesis is that the risks of transmission of COVID-19 will be significantly reduced and that current PPE use will have economic and ecological consequences that exceed its anticipated benefits. Evidence is needed to evaluate PPE use so that recommendations can ensure the clinical, economic, and environmental efficiency (ie, eco-efficiency) of its use. OBJECTIVE To support the development of recommendations for the eco-efficient use of PPE, our research objectives are to (1) estimate the clinical effectiveness (reduced transmission, hospitalizations, mortality, and work absenteeism) of PPE against COVID-19 for health care workers; (2) estimate the financial cost of using PPE in the ED for the management of suspected or confirmed COVID-19 patients; and (3) estimate the ecological footprint of PPE use against COVID-19 in the ED. METHODS We will conduct a mixed method study to evaluate the eco-efficiency of PPE use in the 5 EDs of the CHU de Québec-Université Laval (Québec, Canada). To achieve our goals, the project will include four phases: systematic review of the literature to assess the clinical effectiveness of PPE (objective 1; phase 1); cost estimation of PPE use in the ED using a time-driven activity-based costing method (objective 2; phase 2); ecological footprint estimation of PPE use using a life cycle assessment approach (objective 3; phase 3); and cost-consequence analysis and focus groups (integration of objectives 1 to 3; phase 4). RESULTS The first 3 phases have started. The results of these phases will be available in 2023. Phase 4 will begin in 2023 and results will be available in 2024. CONCLUSIONS While the benefits of PPE use are likely to diminish as health care workers' immunity increases, it is important to assess its economic and ecological impacts to develop recommendations to guide its eco-efficient use. TRIAL REGISTRATION PROSPERO CRD42022302598; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=302598. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/50682.
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Affiliation(s)
- Simon Berthelot
- Axe Santé des populations et pratiques optimales en santé, Centre de recherche, CHU de Québec-Université Laval, Québec, QC, Canada
- Département de médecine de famille et de médecine d'urgence, Faculté de médecine, Université Laval, Québec, QC, Canada
| | | | - Manuele Margni
- Ecole Polytechnique, Université de Montréal, Montréal, QC, Canada
| | - Jason Robert Guertin
- Axe Santé des populations et pratiques optimales en santé, Centre de recherche, CHU de Québec-Université Laval, Québec, QC, Canada
- Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Québec, QC, Canada
| | - Annie LeBlanc
- Département de médecine de famille et de médecine d'urgence, Faculté de médecine, Université Laval, Québec, QC, Canada
| | - Tania Marx
- Services des urgences, Centre hospitalier universitaire de Besançon, Besançon, France
| | - Khadidiatou Mangou
- Axe Santé des populations et pratiques optimales en santé, Centre de recherche, CHU de Québec-Université Laval, Québec, QC, Canada
| | - Ariane Bluteau
- Axe Santé des populations et pratiques optimales en santé, Centre de recherche, CHU de Québec-Université Laval, Québec, QC, Canada
| | - Diego Mantovani
- Axe Médecine régénératrice, Centre de recherche, CHU de Québec-Université Laval, Québec, QC, Canada
| | - Sergey Mikhaylin
- EcoFoodLab, Département des sciences de aliments, Institut sur la Nutrition et les Aliments Fonctionnels, Université Laval, Québec, QC, Canada
| | | | | | | | - Nadia Lahrichi
- Ecole Polytechnique, Université de Montréal, Montréal, QC, Canada
| | - Danielle Martin
- Fashion Design and Creative Direction, Toronto Metropolitan University, Toronto, ON, Canada
| | | | | | | | | | - Anne Gignac
- CHU de Québec-Université Laval, Québec, QC, Canada
| | | | - Éric Hufty
- CHU de Québec-Université Laval, Québec, QC, Canada
| | | | - Erica Beatty
- Département de médecine d'urgence, Hôpital Montfort, Ottawa, ON, Canada
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Valenzuela-Fernández A, Cabrera-Rodriguez R, Ciuffreda L, Perez-Yanes S, Estevez-Herrera J, González-Montelongo R, Alcoba-Florez J, Trujillo-González R, García-Martínez de Artola D, Gil-Campesino H, Díez-Gil O, Lorenzo-Salazar JM, Flores C, Garcia-Luis J. Nanomaterials to combat SARS-CoV-2: Strategies to prevent, diagnose and treat COVID-19. Front Bioeng Biotechnol 2022; 10:1052436. [PMID: 36507266 PMCID: PMC9732709 DOI: 10.3389/fbioe.2022.1052436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 11/09/2022] [Indexed: 11/26/2022] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the associated coronavirus disease 2019 (COVID-19), which severely affect the respiratory system and several organs and tissues, and may lead to death, have shown how science can respond when challenged by a global emergency, offering as a response a myriad of rapid technological developments. Development of vaccines at lightning speed is one of them. SARS-CoV-2 outbreaks have stressed healthcare systems, questioning patients care by using standard non-adapted therapies and diagnostic tools. In this scenario, nanotechnology has offered new tools, techniques and opportunities for prevention, for rapid, accurate and sensitive diagnosis and treatment of COVID-19. In this review, we focus on the nanotechnological applications and nano-based materials (i.e., personal protective equipment) to combat SARS-CoV-2 transmission, infection, organ damage and for the development of new tools for virosurveillance, diagnose and immune protection by mRNA and other nano-based vaccines. All the nano-based developed tools have allowed a historical, unprecedented, real time epidemiological surveillance and diagnosis of SARS-CoV-2 infection, at community and international levels. The nano-based technology has help to predict and detect how this Sarbecovirus is mutating and the severity of the associated COVID-19 disease, thereby assisting the administration and public health services to make decisions and measures for preparedness against the emerging variants of SARS-CoV-2 and severe or lethal COVID-19.
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Affiliation(s)
- Agustín Valenzuela-Fernández
- Laboratorio de Inmunología Celular y Viral, Unidad de Farmacología, Sección de Medicina, Facultad de Ciencias de la Salud, Universidad de La Laguna, San Cristóbal de La Laguna, Spain
| | - Romina Cabrera-Rodriguez
- Laboratorio de Inmunología Celular y Viral, Unidad de Farmacología, Sección de Medicina, Facultad de Ciencias de la Salud, Universidad de La Laguna, San Cristóbal de La Laguna, Spain
| | - Laura Ciuffreda
- Research Unit, Hospital Universitario N. S. de Candelaria, Santa Cruz de Tenerife, Spain
| | - Silvia Perez-Yanes
- Laboratorio de Inmunología Celular y Viral, Unidad de Farmacología, Sección de Medicina, Facultad de Ciencias de la Salud, Universidad de La Laguna, San Cristóbal de La Laguna, Spain
| | - Judith Estevez-Herrera
- Laboratorio de Inmunología Celular y Viral, Unidad de Farmacología, Sección de Medicina, Facultad de Ciencias de la Salud, Universidad de La Laguna, San Cristóbal de La Laguna, Spain
| | | | - Julia Alcoba-Florez
- Servicio de Microbiología, Hospital Universitario N. S. de Candelaria, Santa Cruz de Tenerife, Spain
| | - Rodrigo Trujillo-González
- Laboratorio de Inmunología Celular y Viral, Unidad de Farmacología, Sección de Medicina, Facultad de Ciencias de la Salud, Universidad de La Laguna, San Cristóbal de La Laguna, Spain
- Departamento de Análisis Matemático, Facultad de Ciencias, Universidad de La Laguna, Santa Cruz de Tenerife, Spain
| | | | - Helena Gil-Campesino
- Servicio de Microbiología, Hospital Universitario N. S. de Candelaria, Santa Cruz de Tenerife, Spain
| | - Oscar Díez-Gil
- Servicio de Microbiología, Hospital Universitario N. S. de Candelaria, Santa Cruz de Tenerife, Spain
| | - José M. Lorenzo-Salazar
- Genomics Division, Instituto Tecnológico y de Energías Renovables, Santa Cruz de Tenerife, Spain
| | - Carlos Flores
- Research Unit, Hospital Universitario N. S. de Candelaria, Santa Cruz de Tenerife, Spain
- Genomics Division, Instituto Tecnológico y de Energías Renovables, Santa Cruz de Tenerife, Spain
- CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
- Faculty of Health Sciences, University of Fernando Pessoa Canarias, Las Palmas de Gran Canaria, Spain
| | - Jonay Garcia-Luis
- Laboratorio de Inmunología Celular y Viral, Unidad de Farmacología, Sección de Medicina, Facultad de Ciencias de la Salud, Universidad de La Laguna, San Cristóbal de La Laguna, Spain
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8
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Rueda-Medina B, Aguilar-Ferrándiz ME, Esteban-Burgos AA, Tapia Haro RM, Casas-Barragán A, Velando-Soriano A, Gil-Gutiérrez R, Correa-Rodríguez M. Impact of Non-Face-to-Face Teaching with Passive Training on Personal Protective Equipment Use in Health Science Students: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12981. [PMID: 36232282 PMCID: PMC9566742 DOI: 10.3390/ijerph191912981] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/05/2022] [Accepted: 10/06/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND In the COVID-19 era, there was a call for the transformation of higher education. Universities had to combine non-face-to-face teaching with traditional procedures. This study analyzed the effectiveness and perceived satisfaction in a cohort of health sciences students of non-face-to-face teaching with passive training versus face-to-face teaching with active training in the proper donning and doffing of personal protective equipment (PPE) in a clinical simulation scenario. METHODS A total of 142 participants were randomized into two groups: (a) non-face-to-face teaching with passive training; (b) face-to-face teaching with active training. The proper protocol for donning and doffing PPE was assessed. Students evaluated their skills before and after training and satisfaction with training received. RESULTS Significant differences were observed for the statements "I felt more confident in donning after receiving this training" (p = 0.029) and "I felt more confident in doffing after receiving this training" (p = 0.042) in the face-to-face teaching with active training group compared to the non-face-to-face teaching with passive training group, whose number of tasks violated was significantly higher (p = 0.020). Satisfaction was significantly higher in the face-to-face and active training group (p = 0.004). CONCLUSIONS Face-to-face teaching with active training improves effectiveness and satisfaction more than non-face-to-face teaching with passive training for acquiring skills in donning and doffing PPE properly.
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Affiliation(s)
- Blanca Rueda-Medina
- Department of Nursing, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain
- Instituto de Investigación Biosanitaria ibs. GRANADA, 18012 Granada, Spain
| | - María Encarnación Aguilar-Ferrándiz
- Instituto de Investigación Biosanitaria ibs. GRANADA, 18012 Granada, Spain
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain
| | - Ana Alejandra Esteban-Burgos
- Department of Nursing, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain
- Instituto de Investigación Biosanitaria ibs. GRANADA, 18012 Granada, Spain
| | - Rosa María Tapia Haro
- Instituto de Investigación Biosanitaria ibs. GRANADA, 18012 Granada, Spain
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain
| | - Antonio Casas-Barragán
- Instituto de Investigación Biosanitaria ibs. GRANADA, 18012 Granada, Spain
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain
| | | | - Rocío Gil-Gutiérrez
- Department of Nursing, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain
- Instituto de Investigación Biosanitaria ibs. GRANADA, 18012 Granada, Spain
| | - María Correa-Rodríguez
- Department of Nursing, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain
- Instituto de Investigación Biosanitaria ibs. GRANADA, 18012 Granada, Spain
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9
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Weng CH, Kao CL, Chiu PW, Huang SP, Kuo YS, Lin YY, Lin IC, Chang HC, Lu CH, Lin CH. A full-face mask for protection against respiratory infections. Biomed Eng Online 2022; 21:62. [PMID: 36064546 PMCID: PMC9442593 DOI: 10.1186/s12938-022-01027-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 08/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Aerosols and droplets are the transmission routes of many respiratory infectious diseases. The COVID-19 management guidance recommends against the use of nebulized inhalation therapy directly in the emergency room or in an ambulance to prevent possible viral transmission. The three-dimensional printing method was used to develop an aerosol inhalation treatment mask that can potentially prevent aerosol dispersion. We conducted this utility validation study to understand the practicability of this new nebulizer mask system. RESULTS The fit test confirmed that the filter can efficiently remove small particles. The different locations of the mask had an excellent fit with a high pressure making a proper face seal usability. The full-face mask appeared to optimize filtration with pressure and is an example of materials that perform well for improvised respiratory protection using this design. The filtering effect test confirmed that the contamination of designated locations could be protected when using the mask with filters. As in the clinical safety test, a total of 18 participants (10 [55.6%] females; aged 33.1 ± 0.6 years) were included in the final analysis. There were no significant changes in SPO2, EtCO2, HR, SBP, DBP, and RR at the beginning, 20th, 40th, or 60th minutes of the test (all p >.05). The discomfort of wearing a mask increased slightly after time but remained within the tolerable range. The vision clarity score did not significantly change during the test. The mask also passed the breathability test. CONCLUSION The results of our study showed that this mask performed adequately in the fit test, the filtering test, and the clinical safety test. The application of a full-face mask with antiviral properties, together with the newly designed shape of a respirator that respects the natural curves of a human face, will facilitate the production of personal protective equipment with a highly efficient filtration system. METHODS We conducted three independent tests in this validation study: (1) a fit test to calculate the particle number concentration and its association with potential leakage; (2) a filtering effect test to verify the mask's ability to contain aerosol spread; and (3) a clinical safety test to examine the clinical safety, comfortableness, and visual clarity of the mask.
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Affiliation(s)
- Chen-Hsun Weng
- Medical Device Innovation Center, National Cheng Kung University, No. 138, Shengli Rd., North District, Tainan, 70403, Taiwan
| | - Chia-Lung Kao
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Po-Wei Chiu
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Shao-Peng Huang
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yuh-Shin Kuo
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Yuan Lin
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - I-Chen Lin
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hung-Chieh Chang
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chien-Hsin Lu
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chih-Hao Lin
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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10
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Edgar M, Selvaraj SA, Lee KE, Caraballo-Arias Y, Harrell M, Rodriguez-Morales AJ. Healthcare workers, epidemic biological risks - recommendations based on the experience with COVID-19 and Ebolavirus. LE INFEZIONI IN MEDICINA 2022; 30:168-179. [PMID: 35693057 PMCID: PMC9177174 DOI: 10.53854/liim-3002-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 05/13/2022] [Indexed: 06/15/2023]
Abstract
Infectious disease outbreaks frequently cause illness and death among Healthcare Workers (HCWs). We compare strategies from recent, past and ongoing outbreak measures used to protect HCWs, including those facing additional challenges such as racial disparities, violence and stigmatization. Outbreaks and pandemics superimposed on countries with preexisting crises have also affected emergency response to these viral outbreaks. Strategies to protect HCWs include adherence to recommended infection prevention and control measures; new technology such as rapid point-of-care tests and remote monitoring; adopting national public health preparedness plans to ensure the supply and allocation of PPE, staff, and testing supplies; occupational health and mental health support services. Lessons learned from recent pandemics should be used by Infection Prevention and Control and Occupational Health staff to refine preparedness plans to protect HCWs better.
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Affiliation(s)
- Mia Edgar
- Independent Researcher, Honolulu, HI 96795, USA
| | | | - Karen E. Lee
- The Open University, Walton Hall, Kents Hill, Milton Keynes MK7 6AA, United Kingdom
| | | | - Mason Harrell
- School of Public Health, Harvard University, Boston, MA 02138, USA
| | - Alfonso J. Rodriguez-Morales
- Grupo de Investigacion Biomedicina, Faculty of Medicine, Fundacion Universitaria Autónoma de las Americas, Pereira, Risaralda, Colombia
- Universidad Cientifica del Sur, Lima, Peru
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11
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Pizarro AB, Persad E, Durao S, Nussbaumer-Streit B, Engela-Volker JS, McElvenny D, Rhodes S, Stocking K, Fletcher T, Martin C, Noertjojo K, Sampson O, Verbeek JH, Jørgensen KJ, Bruschettini M. Workplace interventions to reduce the risk of SARS-CoV-2 infection outside of healthcare settings. Cochrane Database Syst Rev 2022; 5:CD015112. [PMID: 35514111 PMCID: PMC9073086 DOI: 10.1002/14651858.cd015112.pub2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Although many people infected with SARS-CoV-2 (severe acute respiratory syndrome coronavirus-2) experience no or mild symptoms, some individuals can develop severe illness and may die, particularly older people and those with underlying medical problems. Providing evidence-based interventions to prevent SARS-CoV-2 infection has become more urgent with the spread of more infectious SARS-CoV-2 variants of concern (VoC), and the potential psychological toll imposed by the coronavirus disease 2019 (COVID-19) pandemic. Controlling exposures to occupational hazards is the fundamental method of protecting workers. When it comes to the transmission of viruses, such as SARS-CoV-2, workplaces should first consider control measures that can potentially have the most significant impact. According to the hierarchy of controls, one should first consider elimination (and substitution), then engineering controls, administrative controls, and lastly, personal protective equipment (PPE). OBJECTIVES To assess the benefits and harms of interventions in non-healthcare-related workplaces to reduce the risk of SARS-CoV-2 infection relative to other interventions, or no intervention. SEARCH METHODS We searched MEDLINE, Embase, Web of Science, Cochrane COVID-19 Study Register, the Canadian Centre for Occupational Health and Safety (CCOHS), Clinicaltrials.gov, and the International Clinical Trials Registry Platform to 14 September 2021. We will conduct an update of this review in six months. SELECTION CRITERIA We included randomised control trials (RCT) and planned to include non-randomised studies of interventions. We included adult workers, both those who come into close contact with clients or customers (e.g. public-facing employees, such as cashiers or taxi drivers), and those who do not, but who could be infected by co-workers. We excluded studies involving healthcare workers. We included any intervention to prevent or reduce workers' exposure to SARS-CoV-2 in the workplace, defining categories of intervention according to the hierarchy of hazard controls, i.e. elimination; engineering controls; administrative controls; personal protective equipment. DATA COLLECTION AND ANALYSIS We used standard Cochrane methods. Our primary outcomes were incidence rate of SARS-CoV-2 infection (or other respiratory viruses), SARS-CoV-2-related mortality, adverse events, and absenteeism from work. Our secondary outcomes were all-cause mortality, quality of life, hospitalisation, and uptake, acceptability, or adherence to strategies. We used the Cochrane RoB 2 tool to assess the risk of bias, and GRADE methods to assess the certainty of evidence for each outcome. MAIN RESULTS Elimination of exposure interventions We included one study examining an intervention that focused on elimination of hazards. This study is an open-label, cluster-randomised, non-inferiority trial, conducted in England in 2021. The study compared standard 10-day self-isolation after contact with an infected person to a new strategy of daily rapid antigen testing and staying at work if the test is negative (test-based attendance). The trialists hypothesised that this would lead to a similar rate of infections, but lower COVID-related absence. Staff (N = 11,798) working at 76 schools were assigned to standard isolation, and staff (N = 12,229) at 86 schools to the test-based attendance strategy. The results between test-based attendance and standard 10-day self-isolation were inconclusive for the rate of symptomatic PCR-positive SARS-COV-2 infection rate ratio ((RR) 1.28, 95% confidence interval (CI) 0.74 to 2.21; 1 study, very low-certainty evidence)). The results between test-based attendance and standard 10-day self-isolation were inconclusive for the rate of any PCR-positive SARS-COV-2 infection (RR 1.35, 95% CI 0.82 to 2.21; 1 study, very low-certainty evidence). COVID-related absenteeism rates were 3704 absence days in 566,502 days-at-risk (6.5 per 1000 days at risk) in the control group and 2932 per 539,805 days-at-risk (5.4 per 1000 days at risk) in the intervention group (RR 0.83; 95% CI 0.55 to 1.25). The certainty of the evidence was downgraded to low, due to imprecision. Uptake of the intervention was 71 % in the intervention group, but not reported for the control intervention. The trial did not measure other outcomes, SARS-CoV-2-related mortality, adverse events, all-cause mortality, quality of life, and hospitalisation. We found one ongoing RCT about screening in schools, using elimination of hazard strategies. Personal protective equipment We found one ongoing non-randomised study on the effects of closed face shields to prevent COVID-19 transmission. Other intervention categories We did not find studies in the other intervention categories. AUTHORS' CONCLUSIONS We are uncertain whether a test-based attendance policy affects rates of PCR-postive SARS-CoV-2 infection (any infection; symptomatic infection) compared to standard 10-day self-isolation amongst school and college staff. Test-based attendance policy may result in little to no difference in absence rates compared to standard 10-day self-isolation. As a large part of the population is exposed in the case of a pandemic, an apparently small relative effect that would not be worthwhile from the individual perspective may still affect many people, and thus, become an important absolute effect from the enterprise or societal perspective. The included study did not report on any other primary outcomes of our review, i.e. SARS-CoV-2-related mortality and adverse events. No completed studies were identified on any other interventions specified in this review, but two eligible studies are ongoing. More controlled studies are needed on testing and isolation strategies, and working from home, as these have important implications for work organisations.
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Affiliation(s)
| | - Emma Persad
- Cochrane Austria, Department for Evidence-based Medicine and Evaluation, Danube University Krems, Krems, Austria
| | - Solange Durao
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Barbara Nussbaumer-Streit
- Cochrane Austria, Department for Evidence-based Medicine and Evaluation, Danube University Krems, Krems, Austria
| | - Jean S Engela-Volker
- Division of Population Medicine, Cardiff University School of Medicine, Cardiff, UK
| | - Damien McElvenny
- Centre for Occupational and Environmental Health, University of Manchester, Manchester, UK
| | - Sarah Rhodes
- Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - Katie Stocking
- Centre for Biostatistics, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Tony Fletcher
- Epidemiology Department, Public Health England Centre for Radiation Chemical and Environmental Hazards (CRCE), London, UK
| | | | | | | | | | - Karsten Juhl Jørgensen
- Centre for Evidence-Based Medicine Odense (CEBMO) and Cochrane Denmark, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Matteo Bruschettini
- Cochrane Sweden, Lund University, Skåne University Hospital, Lund, Sweden
- Department of Clinical Sciences Lund, Paediatrics, Lund University, Skåne University Hospital, Lund, Sweden
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12
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Owen L, Apps L, Stanulewicz N, Hall A, Laird K. Health care worker knowledge and attitudes towards uniform laundering during the COVID-19 pandemic. Am J Infect Control 2022; 50:525-535. [PMID: 34971711 PMCID: PMC8714246 DOI: 10.1016/j.ajic.2021.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 12/15/2021] [Accepted: 12/15/2021] [Indexed: 11/26/2022]
Abstract
Background The COVID-19 pandemic raised concerns towards domestic laundering of healthcare worker (HCW) uniforms; this is common practice in countries such as the United Kingdom (UK) and United States. Previous research suggested 4-32% of nurses did not adhere to laundry policies, which could be an infection control risk. This study aimed to investigate the knowledge and attitudes of UK healthcare workers towards domestic laundering of uniforms during the COVID-19 pandemic. Methods Online and paper questionnaires were distributed to HCWs and nursing students who regularly wear uniforms. Differences in knowledge between HCWs were analyzed by Chi-squared tests and attitudes were examined using exploratory factor analysis. Results About 86% of participants (n = 1099 of 1277) laundered their uniforms domestically. Respondents were confident in laundering their uniforms appropriately (71%), however 17% failed to launder at the recommended temperature (60°C). Most participants (68%) would prefer their employer launder their uniforms, with mixed negative emotions towards domestic laundering. Limited provision of uniforms and changing and/or storage facilities were a barrier to following guidelines. Conclusion Most HCWs domestically launder their uniforms, despite a preference for professional laundering. One-fifth of HCWs deviated from the UK National Health Service uniform guidelines; onsite changing facilities were the most significant barrier towards adherence.
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13
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Kurtz CE, Peng Y, Jesso M, Sanghavi H, Kuehl DR, Parker SH. Using a human factors-centric approach to development and testing of a face shield designed for health care workers: A COVID-19 case study for process and outcomes. Am J Infect Control 2022; 50:306-311. [PMID: 34774896 PMCID: PMC8861890 DOI: 10.1016/j.ajic.2021.10.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 10/27/2021] [Accepted: 10/27/2021] [Indexed: 11/27/2022]
Abstract
Background Face shields are a critical piece of personal protective equipment and their comfort impacts compliant use and thus protectiveness. Optimal design criteria for face shield use in healthcare environments are limited. We attempt to identify factors affecting face shield usability and to test and optimize a face shield for comfort and function in health care settings. Methods A broad range of workers in a large health care system were surveyed regarding face shield features and usability. Quantitative and qualitative analysis informed the development of iterative prototypes which were tested against existing shields. Iterative testing and redesign utilized expert insight and feedback from participant focus groups to inform subsequent prototype designs. Results From 1,648 responses, 6 key elements were identified: ability to adjust tension, shifting load bearing from the temples, anti-fogging, ventilation, freedom of movement, and durability. Iterative prototypes received consistently excellent feedback based on use in the clinical environment, demonstrating incremental improvement. Conclusion We defined elements of face shield design necessary for usability in health care and produced a highly functional face shield that satisfies frontline provider criteria and Emergency Use Authorization standards set by the Food and Drug Administration. Integrating human factors principles into rapid-cycle prototyping for personal protective equipment is feasible and valuable.
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14
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Frakes MA, Denison T, Leisten DC, Wheeler J, Boomhower J, Cohen JE, Wilcox S. Operational Policies and Procedures for Critical Care Transport During a Respiratory Pandemic. Air Med J 2022; 41:252-256. [PMID: 35307153 PMCID: PMC8691811 DOI: 10.1016/j.amj.2021.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 11/04/2021] [Accepted: 11/21/2021] [Indexed: 11/27/2022]
Abstract
The severe acute respiratory syndrome coronavirus 2 pandemic of 2020 to 2021 created unprecedented challenges for health care organizations, including those in the critical care transport sector. Critical care transport services had to rapidly adjust to changing patient demographics, distribution of diagnoses, and transport utilization stratagem. To evolve with the pandemic, organizations developed new protocols and guidelines in rapid succession. The growth bore out of a need to cater to this new patient population and their safety as well as the safety of the crewmembers from severe acute respiratory syndrome coronavirus 2. The critical changes to operations involved adaptability, efficient communication, continual reassessment, and implementation of novel approaches. Although these lessons learned were specific to coronavirus disease 2019, many processes will apply to future respiratory epidemics and pandemics. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) pandemic of 2020 to 2021 created unprecedented challenges for health care organizations, including critical care transport (CCT) organizations. The changes were numerous, including a change in the patient population, with a rapid decrease in trauma and pediatrics to a preponderance of adult patients with acute hypoxemic respiratory failure. CCT teams were called on to transport these patients at potential risk to themselves, especially early in 2020, before the effectiveness of personal protective equipment (PPE) was determined. Even seemingly simple tasks, such as defining a person under investigation (PUI) for coronavirus disease 2019 (COVID-19), varied from institution to institution, putting transport organizations in the middle of conflicts. Agility has always been an essential part of any CCT organization because clinicians and managers must adapt to an unpredictable environment. However, the frequency and speed of changes occurring during the COVID-19 pandemic were unprecedented. This report offers our best practices based on our experience and the available data. Although these procedures were developed for the COVID-19 pandemic, they will logically apply to future respiratory outbreaks and illuminate helpful changes for otherwise quotidian operations.
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Affiliation(s)
| | | | - David C Leisten
- Boston MedFlight, Bedford, MA; Department of Emergency Medicine, Lahey Hospital and Medical Center, Burlington, MA
| | | | | | - Jason E Cohen
- Boston MedFlight, Bedford, MA; Department of Surgery, Brigham and Women's Hospital, Boston, MA
| | - Susan Wilcox
- Boston MedFlight, Bedford, MA; Department of Emergency Medicine, Heart Center ICU, Massachusetts General Hospital, Boston, MA.
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15
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Mody L, Akinboyo IC, Babcock HM, Bischoff WE, Cheng VCC, Chiotos K, Claeys KC, Coffey KC, Diekema DJ, Donskey CJ, Ellingson KD, Gilmartin HM, Gohil SK, Harris AD, Keller SC, Klein EY, Krein SL, Kwon JH, Lauring AS, Livorsi DJ, Lofgren ET, Merrill K, Milstone AM, Monsees EA, Morgan DJ, Perri LP, Pfeiffer CD, Rock C, Saint S, Sickbert-Bennett E, Skelton F, Suda KJ, Talbot TR, Vaughn VM, Weber DJ, Wiemken TL, Yassin MH, Ziegler MJ, Anderson DJ. Coronavirus disease 2019 (COVID-19) research agenda for healthcare epidemiology. Infect Control Hosp Epidemiol 2022; 43:156-166. [PMID: 33487199 PMCID: PMC8160487 DOI: 10.1017/ice.2021.25] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 01/07/2021] [Indexed: 02/07/2023]
Abstract
This SHEA white paper identifies knowledge gaps and challenges in healthcare epidemiology research related to coronavirus disease 2019 (COVID-19) with a focus on core principles of healthcare epidemiology. These gaps, revealed during the worst phases of the COVID-19 pandemic, are described in 10 sections: epidemiology, outbreak investigation, surveillance, isolation precaution practices, personal protective equipment (PPE), environmental contamination and disinfection, drug and supply shortages, antimicrobial stewardship, healthcare personnel (HCP) occupational safety, and return to work policies. Each section highlights three critical healthcare epidemiology research questions with detailed description provided in supplementary materials. This research agenda calls for translational studies from laboratory-based basic science research to well-designed, large-scale studies and health outcomes research. Research gaps and challenges related to nursing homes and social disparities are included. Collaborations across various disciplines, expertise and across diverse geographic locations will be critical.
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Affiliation(s)
- Lona Mody
- Division of Geriatric and Palliative Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, United States
- Geriatrics Research Education and Clinical Center, Veterans’ Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, United States
| | - Ibukunoluwa C. Akinboyo
- Division of Infectious Diseases, Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina, United States
| | - Hilary M. Babcock
- Washington University School of Medicine, St. Louis, Missouri, United States
| | - Werner E. Bischoff
- Wake Forest School of Medicine, Winston Salem, North Carolina, United States
| | - Vincent Chi-Chung Cheng
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
- Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region, China
| | - Kathleen Chiotos
- Division of Critical Care Medicine, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
| | - Kimberly C. Claeys
- University of Maryland School of Pharmacy, Baltimore, Maryland, United States
| | - K. C. Coffey
- University of Maryland School of Medicine, Baltimore, Maryland, United States
| | - Daniel J. Diekema
- Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States
| | - Curtis J. Donskey
- Infectious Diseases Section, Louis Stokes Cleveland Veterans’ Affairs Medical Center, Cleveland, Ohio, United States
- Case Western Reserve University School of Medicine, Cleveland, Ohio, United States
| | - Katherine D. Ellingson
- Department of Epidemiology and Biostatistics, College of Public Health, University of Arizona, Tucson, Arizona, United States
| | - Heather M. Gilmartin
- Veterans’ Affairs Eastern Colorado Healthcare System, Aurora, Colorado, United States
- Colorado School of Public Health, University of Colorado, Aurora, Colorado, United States
| | - Shruti K. Gohil
- Division of Infectious Diseases, University of California Irvine School of Medicine, Irvine, California, United States
- Epidemiology and Infection Prevention, UC Irvine Health, Irvine, California, United States
| | - Anthony D. Harris
- University of Maryland School of Medicine, Baltimore, Maryland, United States
| | - Sara C. Keller
- Division of Infectious Diseases, John Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Eili Y. Klein
- Department of Emergency Medicine, Johns Hopkins University, Baltimore, Maryland, Unites States
| | - Sarah L. Krein
- Veterans’ Affairs Ann Arbor Center for Clinical Management Research, Ann Arbor, Michigan, United States
- Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, United States
| | - Jennie H Kwon
- Washington University School of Medicine, St. Louis, Missouri, United States
| | - Adam S. Lauring
- Division of Infectious Diseases, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, United States
| | - Daniel J. Livorsi
- Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States
- Iowa City Veterans’ Affairs Health Care System, Iowa City, Iowa, United States
| | - Eric T. Lofgren
- Paul G. Allen School for Global Animal Health, Washington State University, Pullman, Washington, United States
| | | | - Aaron M. Milstone
- Division of Pediatric Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Elizabeth A. Monsees
- Children’s Mercy Kansas City, Kansas City, Missouri, United States
- University of Missouri–Kansas City School of Medicine, Kansas City, Missouri, United States
| | - Daniel J. Morgan
- University of Maryland School of Medicine, Baltimore, Maryland, United States
- Veterans’ Affairs Maryland Healthcare System, Baltimore, Maryland, United States
| | - Luci P. Perri
- Infection Control Results, Wingate, North Carolina, United States
| | - Christopher D. Pfeiffer
- Veterans’ Affairs Portland Health Care System, Portland, Oregon, United States
- Oregon Health & Science University, Portland, Oregon, United States
| | - Clare Rock
- Division of Infectious Diseases, John Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Sanjay Saint
- Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, United States
- Veterans’ Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, United States
| | - Emily Sickbert-Bennett
- Department of Infection Prevention, University of North Carolina Medical Center, Chapel Hill, North Carolina, United States
| | - Felicia Skelton
- Michael E. DeBakey Veterans’ Affairs Medical Center, Houston, Texas, United States
- H. Ben Taub Department of Physical Medicine & Rehabilitation, Baylor College of Medicine, Houston, Texas, United States
| | - Katie J. Suda
- Center for Health Equity Research and Promotion, Veterans’ Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, United States
- Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
| | - Thomas R. Talbot
- Vanderbilt University School of Medicine, Nashville, Tennessee, United States
| | - Valerie M. Vaughn
- Division of General Internal Medicine, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, United States
| | - David J. Weber
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | - Timothy L. Wiemken
- Division of Infectious Diseases, Allergy, and Immunology, Department of Medicine, Saint Louis University School of Medicine, St Louis, Missouri, United States
| | - Mohamed H. Yassin
- School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
- Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Matthew J. Ziegler
- Infectious Diseases Division, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Deverick J. Anderson
- Duke Center for Antimicrobial Stewardship and Infection Prevention, Duke University School of Medicine, Durham, North Carolina, United States
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Lian X, Zhang L, Zhao Y, Li Y, Jing X, Liu X, Han J, Ma J, Zhang Y, Guo H, Huang X. Utilization of a Mobile Multifunctional Workstation for Coronavirus Nasopharyngeal/Oropharyngeal Specimen Collection. Front Public Health 2022; 9:794359. [PMID: 35141188 PMCID: PMC8818745 DOI: 10.3389/fpubh.2021.794359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 12/08/2021] [Indexed: 11/16/2022] Open
Abstract
Objectives This study aimed to explore the utilization of a mobile multifunctional workstation for COVID-19 sample collection. Methods Twenty-four nurses and 150 individuals who took nucleic acid tests using mobile multifunctional workstations in Beijing Youan Hospital, Capital Medical University, from September to November 2020, were enrolled in the study as the observation group. As the control group, we included 36 nurses and 150 individuals who did not use the workstations from June to September 2020. We compared the two groups on (1) comfort of working environment, self-perceived security, the convenience of information system, operational process flexibility, pharyngeal acquisition visibility, and effectiveness of communication among nurses; and (2) self-perceived safety, waiting time, and overall satisfaction among individuals who took nucleic acid tests. Results The satisfaction score of nurses in the observation group of nurses were significantly higher than those of the control group (OR = 17.297 95% CI:4.294, 69.673), as well as the convenience of the information system (OR = 6.250 95% CI: 1.775, 22.008), and communication effectiveness (OR = 5.588 95% CI: 1.590, 19.646). Among individuals who took nucleic acid tests, the overall satisfaction (P < 0.05) and self-perceived security (P < 0.05) had statistical differences between the observation group and the control group. Conclusions The mobile multifunctional workstation for specimen collection could improve the comfort of the working environment, the convenience of information systems, and the effectiveness of communication among nurses.It can improve satisfaction and self-perceived security among people who took nucleic acid tests.
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Affiliation(s)
- Xiaojing Lian
- Integrated Traditional Chinese and Western Medicine Center, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Lili Zhang
- Nursing Department of Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Yang Zhao
- Department of Dermatology, Shunyi Maternal and Children's Hospital of Beijing Children's Hospital, Beijing, China
| | - Yuhua Li
- Second Department of Infection, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Xuemin Jing
- Intervention Department, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Xin Liu
- Department of Critical Care Medicine, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Jianing Han
- Department of Infection, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Jianhong Ma
- Department of Infection, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Yongyong Zhang
- Outpatient Department, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Huimin Guo
- Nursing Department of Beijing Youan Hospital, Capital Medical University, Beijing, China
- *Correspondence: Huimin Guo
| | - Xiaojie Huang
- Center for Infectious Disease, Beijing Youan Hospital, Capital Medical University, Beijing, China
- Xiaojie Huang
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17
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Rai E, Suda N, Smithamol PB, Toms A, Meera GK, Rebekah G, Trinaya S, Mohammed AH, Sahajanandan R. Aerosol-generating procedures, how best did anesthesiologists use available personal protective equipment during early COVID-19 pandemic in a tertiary care center of southern India? A prospective cross-sectional study. J Anaesthesiol Clin Pharmacol 2022; 38:S96-S101. [PMID: 36060157 PMCID: PMC9438817 DOI: 10.4103/joacp.joacp_493_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 12/16/2021] [Accepted: 12/16/2021] [Indexed: 11/30/2022] Open
Abstract
Background and Aims: Anesthesiologists are involved in high-risk procedures for transmission of SARS-CoV-2 like aerosol-generating procedures (AGPs). The present study was conducted to assess the compliance toward the use of personal protective equipment (PPE) and proposed modifications in anesthesia techniques to prevent dissemination of the virus among healthcare workers. Material and Methods: This prospective cross-sectional study was conducted during the first wave of the COVID-19 pandemic and included all elective surgeries involving AGPs inside operation theatres and remote areas. Participants were anesthesia consultants and trainees. Trained anesthesia technicians observed and documented all the AGPs and data entry with analysis was done using EPI Data 3.1, SPSS 21.0. Descriptive statistics were reported using mean ± SD for continuous variables. Results: Preoperative COVID-19 test was done in 96.3% of patients. Most (74.8%) of the AGPs were performed by consultants. In our study, compliance for N95 masks usage and hand hygiene was found to be 99.2% and 55.9%, respectively. Avoidance of crowding was followed in only 38.9% during intubation. To contain the aerosol-based spread of virus, modification of anesthesia practices like acrylic boxes (6.4%), plastic sheets (5.5%), video laryngoscopy (39%), rapid sequence intubation (RSI) (42.7%), and 59.3% of deep extubation were incorporated. Conclusion: In our study, we found satisfactory compliance toward usage of N95 masks alone, whereas compliance toward other available PPE and modification in anesthesia practice was found to be unsatisfactory.
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18
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Impact of Personal Protective Equipment on Out-of-Hospital Cardiac Arrest Resuscitation in Coronavirus Pandemic. Medicina (B Aires) 2021; 57:medicina57121291. [PMID: 34946236 PMCID: PMC8708039 DOI: 10.3390/medicina57121291] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/18/2021] [Accepted: 11/20/2021] [Indexed: 01/10/2023] Open
Abstract
Background and Objectives: This retrospective study evaluated the clinical impact of enhanced personal protective equipment (PPE) on the clinical outcomes in patients with out-of-hospital cardiac arrest. Moreover, by focusing on the use of a powered air-purifying respirator (PAPR), we investigated the medical personnel’s perceptions of wearing PAPR during cardiopulmonary resuscitation. Materials and Methods: According to the arrival time at the emergency department, the patients were categorized into a conventional PPE group (1 August 2019 to 20 January 2020) and an enhanced PPE group (21 January 2020, to 31 August 2020). The primary outcomes of this analysis were the return of spontaneous circulation (ROSC) rate. Additionally, subjective perception of the medical staff regarding the effect of wearing enhanced PPE during cardiopulmonary resuscitation (CPR) was evaluated by conducting a survey. Results: This study included 130 out-of-hospital cardiac arrest (OHCA) patients, with 73 and 57 patients in the conventional and enhanced PPE groups, respectively. The median time intervals to first intubation and to report the first arterial blood gas analysis results were longer in the enhanced PPE group than in the conventional PPE group (3 min vs. 2 min; p = 0.020 and 8 min vs. 3 min; p < 0.001, respectively). However, there were no significant differences in the ROSC rate (odds ratio (OR) = 0.79, 95% confidence interval (CI): 0.38–1.67; p = 0.542) and 1 month survival (OR 0.38, 95% CI: 0.07–2.10; p = 0.266) between the two groups. In total, 67 emergent department (ED) professionals responded to the questionnaire. Although a significant number of respondents experienced inconveniences with PAPR use, they agreed that PAPR was necessary during the CPR procedure for protection and reduction of infection transmission. Conclusion: The use of enhanced PPE, including PAPR, affected the performance of CPR to some extent but did not alter patient outcomes. PAPR use during the resuscitation of OHCA patients might positively impact the psychological stability of the medical staff.
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Mukhamedyarova A, Rakhypbekov T, Dauletyarova M, Zhunussova D, Tsigengagel O, Khismetova Z. Measures to Strengthen the Role of Primary Care Nurses During the COVID-19 Pandemic: A Concept Analysis. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.7204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Abstract
The difficult epidemiological situation of COVID 19 infection in the world and in the country requires drastic measures to strengthen the material, technical and staffing of primary health care (PHC). Under these circumstances, the preparedness of PHC systems in providing safe patient-centered care and meeting the current health needs of the population while preventing further transmission infection is crucial. Nurses play a crucial role in this process. This article reviews and summarize latest findings of explore the role of primary care nurses and their support measures in response to COVID-19 and to identify challenges to achieving universal health coverage. The study revealed that there is vast panoply of strategic reforms. There are a number of differences and similarities such as mandatory political commitment and leadership, governance and policy, funding and allocation of resources, and engagement of communities and role of other stakeholders.
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20
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Kydd A. Menopause and personal protective equipment: How does this meet acceptable working conditions? Case Rep Womens Health 2021; 32:e00356. [PMID: 34540597 PMCID: PMC8441062 DOI: 10.1016/j.crwh.2021.e00356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 09/07/2021] [Indexed: 11/28/2022] Open
Affiliation(s)
- Angela Kydd
- Robert Gordon University, Aberdeen, Aberdeenshire, UK
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21
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Pizarro AB, Persad E, Durao S, Nussbaumer-Streit B, Garritty C, Engela-Volker JS, McElvenny D, Rhodes S, Stocking K, Fletcher T, Van Tongeren M, Martin C, Noertjojo K, Sampson O, Jørgensen KJ, Bruschettini M. Workplace interventions to reduce the risk of SARS-CoV-2 infection outside of healthcare settings. Hippokratia 2021. [DOI: 10.1002/14651858.cd015112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
| | - Emma Persad
- Cochrane Austria, Department for Evidence-based Medicine and Evaluation; Danube University Krems; Krems Austria
| | - Solange Durao
- Cochrane South Africa; South African Medical Research Council; Cape Town South Africa
| | - Barbara Nussbaumer-Streit
- Cochrane Austria, Department for Evidence-based Medicine and Evaluation; Danube University Krems; Krems Austria
| | - Chantelle Garritty
- Global Health and Guidelines Division; Public Health Agency of Canada (PHAC); Ottawa Canada
| | - Jean S Engela-Volker
- Division of Population Medicine; Cardiff University School of Medicine; Cardiff UK
| | - Damien McElvenny
- Centre for Occupational and Environmental Health; University of Manchester; Manchester UK
| | - Sarah Rhodes
- Division of Population Health, Health Services Research and Primary Care; University of Manchester; Manchester UK
| | - Katie Stocking
- Centre for Biostatistics, School of Health Sciences, Faculty of Biology, Medicine and Health; University of Manchester; Manchester UK
| | - Tony Fletcher
- Epidemiology Department; Public Health England Centre for Radiation Chemical and Environmental Hazards (CRCE); London UK
| | - Martie Van Tongeren
- Division of Population Health, Health Services Research and Primary Care; University of Manchester; Manchester UK
| | | | | | | | - Karsten Juhl Jørgensen
- Centre for Evidence-Based Medicine Odense (CEBMO) and Cochrane Denmark; Department of Clinical Research, University of Southern Denmark; Odense Denmark
| | - Matteo Bruschettini
- Department of Clinical Sciences Lund, Paediatrics; Lund University, Skåne University Hospital; Lund Sweden
- Cochrane Sweden; Lund University, Skåne University Hospital; Lund Sweden
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22
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Mędrzycka-Dąbrowska W, Ślęzak D, Robakowska M, Żuratyński P, Krzyżanowski K, Małecka-Dubiela A, Dąbrowski S, Zorena K, Lewandowska K, Ozga D, Chmielarz K, Buca P, Tomaszek L. Evaluation of Capillary Blood Gases in Medical Personnel Caring for Patients Isolated Due to SARS-CoV-2 in Intensive Care Units before and after Using Enhanced Filtration Masks: A Prospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9425. [PMID: 34574350 PMCID: PMC8467996 DOI: 10.3390/ijerph18189425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/30/2021] [Accepted: 09/03/2021] [Indexed: 11/22/2022]
Abstract
The dynamically changing epidemiological situation caused by the SARS-CoV-2 virus is associated with the increased burden and fatigue of medical personnel. The aim of the study was to evaluate: (1) oxygen and carbon dioxide blood pressure and saturation levels in medical personnel caring for patients isolated due to SARS-CoV-2 in ICUs; (2) adverse symptoms reported by medical personnel after leaving the isolation zone. DESIGN A Prospective Cohort Study. METHODS The project was implemented in the first quarter of 2021. Medical personnel working with patients isolated due to SARS-CoV-2 in the ICU of three hospitals were eligible for the study. The participants of the study were subjected to two analyses of capillary blood by a laboratory diagnostician. RESULTS In the studied group of medical personnel (n = 110) using FFP2/FFP3 masks, no significant differences (p > 0.05) were found between the parameters of geometric examination performed before and after leaving the isolation ward of the hospital. After working in the isolation ward, nurses reported malaise (somnolence, fatigue, sweating, dizziness) more often than paramedics (44% vs. 9%; p = 0.00002). The risk of ill-being in nurses was approximately nine times higher than in paramedics (OR = 8.6; Cl 95%: 2.7 to 26.8) and increased with the age of the subjects (OR = 1.05; Cl 95%: 1.01 to 1.08). CONCLUSION FFP2/FFP3 filter masks did not worsen blood oxygenation in medical staff caring for patients isolated due to SARS-CoV-2 in the ICU. The presence of subjective symptoms such as fatigue may be due to lack of adequate hydration.
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Affiliation(s)
- Wioletta Mędrzycka-Dąbrowska
- Department of Anaesthesiology Nursing and Intensive Care, Faculty of Health Sciences, Medical University of Gdańsk, Dębinki 7, 80-211 Gdańsk, Poland;
| | - Daniel Ślęzak
- Department of Medical Rescue, Faculty of Health Sciences, Medical University of Gdańsk, Dębinki 7, 80-211 Gdańsk, Poland; (D.Ś.); (P.Ż.); (K.K.); (S.D.)
| | - Marlena Robakowska
- Department of Public Health & Social Medicine, Faculty of Health Sciences, Medical University of Gdańsk, 80-211 Gdańsk, Poland;
| | - Przemysław Żuratyński
- Department of Medical Rescue, Faculty of Health Sciences, Medical University of Gdańsk, Dębinki 7, 80-211 Gdańsk, Poland; (D.Ś.); (P.Ż.); (K.K.); (S.D.)
| | - Kamil Krzyżanowski
- Department of Medical Rescue, Faculty of Health Sciences, Medical University of Gdańsk, Dębinki 7, 80-211 Gdańsk, Poland; (D.Ś.); (P.Ż.); (K.K.); (S.D.)
| | - Anna Małecka-Dubiela
- Department of Internal and Pediatric Nursing, Faculty of Health Sciences, Medical University of Gdańsk, Dębinki 7, 80-211 Gdańsk, Poland;
| | - Sebastian Dąbrowski
- Department of Medical Rescue, Faculty of Health Sciences, Medical University of Gdańsk, Dębinki 7, 80-211 Gdańsk, Poland; (D.Ś.); (P.Ż.); (K.K.); (S.D.)
| | - Katarzyna Zorena
- Department of Immunobiology and Environment Microbiology, Faculty of Health Sciences, Medical University of Gdańsk, Dębinki 7, 80-211 Gdańsk, Poland;
| | - Katarzyna Lewandowska
- Department of Anaesthesiology Nursing and Intensive Care, Faculty of Health Sciences, Medical University of Gdańsk, Dębinki 7, 80-211 Gdańsk, Poland;
| | - Dorota Ozga
- Institute of Health Sciences, College of Medical Sciences of the University of Rzeszow, St. Warzywna1A, 35-310 Rzeszow, Poland;
| | - Karina Chmielarz
- Department of Laboratory Diagnostics, Nicolaus Copernicus University of Toruń, Collegium Medicum im. L. Rydygier in Bydgoszcz, Jagiellońska 13/15, 85-067 Bydgoszcz, Poland;
| | - Paulina Buca
- Division of Hyperbaric Medicine & Maritime Rescue—National Centre for Hyperbaric Medicine, Faculty of Health Sciences, Medical University of Gdańsk, Powstania Styczniowego 9b, 81-519 Gdynia, Poland;
| | - Lucyna Tomaszek
- Institute of Tuberculosis and Lung Diseases, Rabka-Zdrój Branch, ul. Prof. Jana Rudnika 3B, 34-700 Rabka-Zdrój, Poland;
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Mohiedden M, Said AM, Ali AM, Abdel Razik MM, Gad MA. Healthcare Workers Infection Rate in the Era of Coronavirus Disease 2019 - in Tertiary Teaching Hospital. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Healthcare workers (HCWs) are at the frontline defense against coronavirus disease 2019 (COVID-19) pandemic.
AIM: The study aimed to describe the characteristics and appraise potential risk factors of COVID-19 transmission among HCWs who tested positive for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in one of Cairo University Hospitals.
METHOD: Cross-sectional descriptive analysis of confirmed polymerase chain reaction (PCR) positive versus negative cases for COVID-19.
RESULTS: Through March–June 2020, (145/846; 17%) suspected HCWs were tested for COVID-19 by PCR; out of them (70/145; 48.3%) were confirmed as positive, these positive cases represented (70/846; 8.3%) of all HCWs of the hospital. About 33% of confirmed COVID-19 positive HCWs acquired the infection from the healthcare while only (13/70; 19%) from community settings, and no clear exposure data were identified in (34/70; 48%) of cases. Most of symptomatic cases showed a positive PCR test for SARS-CoV-2 versus asymptomatic cases, p < 0.001. There was no statistical significance regarding gender, age, presence of comorbidity, workload or the type of acquisition.
CONCLUSION: HCWs are at an increased risk of COVID-19 infection at the workplace. Strict implementation of infection control measures is of crucial role in preventing transmission of COVID-19 infection in health-care settings.
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Żółtowska B, Barańska I, Szczerbińska K, Różańska A, Mydel K, Sydor W, Heczko PB, Jachowicz E, Wójkowska-Mach J. Preparedness of Health Care Workers and Medical Students in University Hospital in Krakow for COVID-19 Pandemic within the CRACoV Project. J Clin Med 2021; 10:3487. [PMID: 34441784 PMCID: PMC8396826 DOI: 10.3390/jcm10163487] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/30/2021] [Accepted: 08/03/2021] [Indexed: 12/16/2022] Open
Abstract
Backgrounds Health care workers' (HCWs) knowledge of and compliance with personal protective procedures is a key for patients' and personnel safety. The aim of this study was to assess which factors are associated with higher self-evaluations of training on infection prevention and control (IPC) and higher self-assessment of IPC practices used by HCWs regarding COVID-19 in University Hospital in Krakow, Poland, in January 2021. Material and methods This was an online survey on the preparedness for COVID-19 epidemic of medical/non-medical staff and medical students. Questions included in the survey concerned participants' socio-demographic characteristics, hospital staff involvement in the training, knowledge about the hand hygiene, and adherence to IPC measures. Knowledge and Performance Index (K&PI) based on selected questions was constructed for to reflect both subjective (self-evaluation) of preparedness and objective IPC knowledge and skills of HCWs participated in the IPC training. Results A total of 1412 health care workers, including 129 medical students, participated in the study. The largest group, 53.6%, was made up of nurses and paramedics. Age of respondents significantly correlated with knowledge of IPC and with K&PI. The mean age of workers with high K&PI was 42.39 ± 12.53, and among those with low, 39.71 ± 13.10, p < 0.001. 51% UHK workers participated in IPC training, but 11.3% of physicians, 28.8% of other HCWs, and 55.8% of students did not know the IPC standard precaution. Most participants, 72.3%, felt that they had received sufficient training; however, 45.8% of students declined this. There was no correlation between self-reported preparedness and the K&PI, indicating that self-reported preparedness was inadequate for knowledge and skills. Nurses and paramedics assessed their knowledge most accurately. Participants with low K&PI and high subjective evaluation constituted a substantial group in all categories. Students least often overestimated (23.8%) and most often (9.6%) underestimated their knowledge and skills. Conclusions Our study revealed inadequate IPC practice, especially as it refers to the training programme. We confirmed the urgent need of including theory and practice of IPC in curricula of health professions' training in order to provide students with knowledge and skills necessary not only for future pandemic situations but also for everyday work.
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Affiliation(s)
- Barbara Żółtowska
- Center for Innovative Therapy, Clinical Research Coordination Center, University Hospital in Krakow, Poland 2-st, 30-688 Krakow, Poland;
| | - Ilona Barańska
- Laboratory for Research on Aging Society, Department of Sociology of Medicine, Chair of Epidemiology and Preventive Medicine, Medical Faculty, Jagiellonian University Medical College, 31-034 Krakow, Poland; (I.B.); (K.S.)
| | - Katarzyna Szczerbińska
- Laboratory for Research on Aging Society, Department of Sociology of Medicine, Chair of Epidemiology and Preventive Medicine, Medical Faculty, Jagiellonian University Medical College, 31-034 Krakow, Poland; (I.B.); (K.S.)
| | - Anna Różańska
- Chair of Microbiology, Medical Faculty, Jagiellonian University Medical College, 31-034 Kraków, Poland; (A.R.); (P.B.H.); (E.J.); (J.W.-M.)
| | - Krzysztof Mydel
- Deputy Director for Coordination and Development, University Hospital in Krakow, 30-688 Krakow Poland;
| | - Wojciech Sydor
- Center for Innovative Therapy, Clinical Research Coordination Center, University Hospital in Krakow, Poland 2-st, 30-688 Krakow, Poland;
- Department of Rheumatology and Immunology, Jagiellonian University Medical College, 30-688 Krakow, Poland
| | - Piotr B. Heczko
- Chair of Microbiology, Medical Faculty, Jagiellonian University Medical College, 31-034 Kraków, Poland; (A.R.); (P.B.H.); (E.J.); (J.W.-M.)
| | - Estera Jachowicz
- Chair of Microbiology, Medical Faculty, Jagiellonian University Medical College, 31-034 Kraków, Poland; (A.R.); (P.B.H.); (E.J.); (J.W.-M.)
| | - Jadwiga Wójkowska-Mach
- Chair of Microbiology, Medical Faculty, Jagiellonian University Medical College, 31-034 Kraków, Poland; (A.R.); (P.B.H.); (E.J.); (J.W.-M.)
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25
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Clavario P, De Marzo V, Lotti R, Barbara C, Porcile A, Russo C, Beccaria F, Bonavia M, Bottaro LC, Caltabellotta M, Chioni F, Santangelo M, Hautala AJ, Griffo R, Parati G, Corrà U, Porto I. Cardiopulmonary exercise testing in COVID-19 patients at 3 months follow-up. Int J Cardiol 2021; 340:113-118. [PMID: 34311011 PMCID: PMC8302817 DOI: 10.1016/j.ijcard.2021.07.033] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 06/29/2021] [Accepted: 07/14/2021] [Indexed: 12/16/2022]
Abstract
Background Long-term effects of Coronavirus Disease of 2019 (COVID-19) are of utmost relevance. We aimed to determine: 1) the functional capacity of COVID-19 survivors by cardiopulmonary exercise testing (CPET); 2) the characteristics associated with cardiopulmonary exercise testing (CPET) performance; 3) the safety and tolerability of CPET. Methods We prospectively enrolled consecutive patients with laboratory-confirmed COVID-19 from Azienda Sanitaria Locale 3, Genoa. Three months after hospital discharge a complete clinical evaluation, trans-thoracic echocardiography, CPET, pulmonary function tests, and dominant leg extension (DLE) maximal strength measurement were performed. Results From the 225 patients discharged alive from March to November 2020, we excluded 12 incomplete/missing cases and 13 unable to perform CPET, leading to a final cohort of 200. Median percent-predicted peak oxygen uptake (%pVO2) was 88% (78.3–103.1). Ninety-nine (49.5%) patients had %pVO2 below, whereas 101 (50.5%) above the 85% predicted value. Among the 99 patients with reduced %pVO2, 61 (61%) had a normal anaerobic threshold: of these, 9(14.8%) had respiratory, 21(34.4%) cardiac, and 31(50.8%) non-cardiopulmonary reasons for exercise limitation. Inerestingly, 80% of patients experienced at least one disabling symtpom, not related to %pVO2 or functional capacity. Multivariate linear regression showed percent-predicted forced expiratory volume in one-second(β = 5.29,p = 0.023), percent-predicted diffusing capacity of lungs for carbon monoxide(β = 6.31,p = 0.001), and DLE maximal strength(β = 14.09,p = 0.008) to be independently associated with pVO2. No adverse event was reported during or after CPET, and no involved health professional developed COVID-19. Conclusions At three months after discharge, about 1/3rd of COVID-19 survivors show functional limitations, mainly explained by muscular impairment, calling for future research to identify patients at higher risk of long-term effects that may benefit from careful surveillance and targeted rehabilitation.
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Affiliation(s)
- Piero Clavario
- Cardiac Rehabilitation Center of Genoa, Azienda Sanitaria Locale, ASL 3 Genovese, Genoa, Italy
| | - Vincenzo De Marzo
- Cardiology Unit, DICATOV - Cardiothoracic and Vascular Department, IRCCS San Martino Hospital, Genoa, Italy; Department of Internal Medicine and Medical Specialties (DIMI), University of Genoa, Genoa, Italy
| | - Roberta Lotti
- Cardiology Unit, DICATOV - Cardiothoracic and Vascular Department, IRCCS San Martino Hospital, Genoa, Italy; Department of Internal Medicine and Medical Specialties (DIMI), University of Genoa, Genoa, Italy
| | - Cristina Barbara
- Cardiac Rehabilitation Center of Genoa, Azienda Sanitaria Locale, ASL 3 Genovese, Genoa, Italy
| | - Annalisa Porcile
- Cardiac Rehabilitation Center of Genoa, Azienda Sanitaria Locale, ASL 3 Genovese, Genoa, Italy
| | - Carmelo Russo
- Cardiac Rehabilitation Center of Genoa, Azienda Sanitaria Locale, ASL 3 Genovese, Genoa, Italy
| | - Federica Beccaria
- Cardiac Rehabilitation Center of Genoa, Azienda Sanitaria Locale, ASL 3 Genovese, Genoa, Italy
| | - Marco Bonavia
- Cardiac Rehabilitation Center of Genoa, Azienda Sanitaria Locale, ASL 3 Genovese, Genoa, Italy
| | - Luigi Carlo Bottaro
- Cardiac Rehabilitation Center of Genoa, Azienda Sanitaria Locale, ASL 3 Genovese, Genoa, Italy
| | - Marta Caltabellotta
- Cardiac Rehabilitation Center of Genoa, Azienda Sanitaria Locale, ASL 3 Genovese, Genoa, Italy
| | - Flavia Chioni
- Cardiac Rehabilitation Center of Genoa, Azienda Sanitaria Locale, ASL 3 Genovese, Genoa, Italy
| | - Monica Santangelo
- Cardiac Rehabilitation Center of Genoa, Azienda Sanitaria Locale, ASL 3 Genovese, Genoa, Italy
| | - Arto J Hautala
- Faculty of Sports and Health Sciences, University of Jyväskylä, Finland
| | - Raffaele Griffo
- Cardiac Rehabilitation Center of Genoa, Azienda Sanitaria Locale, ASL 3 Genovese, Genoa, Italy
| | - Gianfranco Parati
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Ugo Corrà
- IRCCS, Istituti Clinici Scientifici Maugeri, Care and Research Institute, Department of Cardiac Rehabilitation, Veruno-Novara, Italy
| | - Italo Porto
- Cardiology Unit, DICATOV - Cardiothoracic and Vascular Department, IRCCS San Martino Hospital, Genoa, Italy; Department of Internal Medicine and Medical Specialties (DIMI), University of Genoa, Genoa, Italy.
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Williams K, Cherrie JW, Dobbie J, Agius RM. The Development of a Covid-19 Control Measures Risk Matrix for Occupational Hygiene Protective Measures. Ann Work Expo Health 2021; 66:269-275. [PMID: 34278429 PMCID: PMC8344429 DOI: 10.1093/annweh/wxab050] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 05/19/2021] [Accepted: 06/17/2021] [Indexed: 11/12/2022] Open
Abstract
The British Occupational Hygiene Society (BOHS) Covid-19 Working Group developed a control banding matrix to provide guidance for employers and others to help assess the risks of Covid-19 infection during the pandemic. The matrix was based on occupational hygiene principles and the judgement of the occupational health practitioners involved; since objective data on workers’ exposure were unavailable. Users of the matrix identify one of five exposure categories based on generic job descriptions and example occupations, and these categories are linked to generic guidance on interventions at source, on the exposure pathway and for individual workers. The risk matrix was published on the BOHS website and the guidance has been downloaded more than 2000 times. The matrix has had limited evaluation for reliability, but the data suggest that the highest exposure ranked jobs were associated with higher age-standardized mortality in Britain during the pandemic. However, there was considerable variability in exposure assignments between assessors, which underlines the need for the control guidance to be precautionary. The BOHS calls on academic researchers to undertake further work to validate the reliability of the tool.
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Affiliation(s)
| | - John W Cherrie
- Institute of Occupational Medicine, Edinburgh, UK.,Heriot Watt University, Institute of Biological Chemistry, Biophysics and Bioengineering, Riccarton, Edinburgh, UK
| | | | - Raymond M Agius
- The University of Manchester, Centre for Occupational and Environmental Health, Manchester, UK
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27
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Pottier F, Groizard C, Briche G, Haraczaj N, Garnier M, Loones V, Ozguler A, Baer M, Baer G, Loeb T. Personal protective equipment and doffing procedures in out-of-hospital practice: assessment with a contamination simulation. Int J Emerg Med 2021; 14:35. [PMID: 34256703 PMCID: PMC8275914 DOI: 10.1186/s12245-021-00362-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 06/08/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND The use of personal protective equipment (PPE) by emergency medical services (EMS) providers requires specific attention, as it takes place in out-of-hospital unsecured settings. The aim of this study was to evaluate which PPE gown was less contaminating during doffing procedures in an EMS setting. Six well-trained healthcare worker (HCW) subjects tested 4 different gowns: (1) surgical gowns (SG), (2) full body coveralls (FBC), (3) self-made alternative PPEs (SMP), and (4) non-surgical isolation gowns (NSIG). An invisible tracer was sprayed on the gown after donning each subject. After doffing, each HCW was photographed under UV lights to show areas of fluorescent "contamination" on their clothes. The number, size, and intensity level of contaminated areas were noted, as well as observational deviation from the procedure and doffing time. In addition, the subjects were asked to take a questionnaire about their perception of the level of comfort, ease of doffing, and overall safety for each gown. RESULTS Despite a well-trained team of HCW subjects, contamination while doffing was observed with every type of PPE gown, and with each HCW subject. All body areas were contaminated at least once, except the face. Contamination was more frequent while doffing FBCs. On the other hand, the removal of SG was found to be the least contaminating. The mean doffing time was significantly shorter with SG 1:29 and longer with FBC 2:26 (p=0.005). CONCLUSION Results of this study converge towards the selection of surgical gowns over other types of PPE gowns, which met both contamination criteria as well as staff appreciation in this context. Specific attention should be paid to the legs and abdomino-pelvic areas. Additional protection such as protective trousers or aprons could be added.
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Affiliation(s)
- Fabrice Pottier
- SAMU 92, APHP, 104 Boulevard Raymond Poincare, 92 380, Garches, France
| | - Charles Groizard
- SAMU 92, APHP, 104 Boulevard Raymond Poincare, 92 380, Garches, France
| | - Grégory Briche
- Division Criminalistique Physique et Chimie, Institut de Recherche Criminelle de la Gendarmerie Nationale, Cergy-Pontoise, France
| | - Nicolas Haraczaj
- Département Environnement Incendie Explosifs, Institut de Recherche Criminelle de la Gendarmerie Nationale, Cergy-Pontoise, France
| | - Maxime Garnier
- Département Environnement Incendie Explosifs, Institut de Recherche Criminelle de la Gendarmerie Nationale, Cergy-Pontoise, France
| | - Vinciane Loones
- Département Environnement Incendie Explosifs, Institut de Recherche Criminelle de la Gendarmerie Nationale, Cergy-Pontoise, France
| | - Anna Ozguler
- SAMU 92, APHP, 104 Boulevard Raymond Poincare, 92 380, Garches, France.
| | - Michel Baer
- SAMU 92, APHP, 104 Boulevard Raymond Poincare, 92 380, Garches, France
| | - Géraldine Baer
- Department of Emergency Medicine, Corporal Michael J. Crescenz VA Medical Center, University of Pennsylvania Medical Center, Philadelphia, PA, USA
| | - Thomas Loeb
- SAMU 92, APHP, 104 Boulevard Raymond Poincare, 92 380, Garches, France
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28
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Lum JKL, Fong QW, Law S, Ang ESW. The "Jeff Cut": A simple innovation to minimise up-riding sleeves of protective gown. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2021; 50:583-584. [PMID: 34342341 DOI: 10.47102/annals-acadmedsg.2020270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
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29
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Danguy des Déserts M, Mathais Q, Morvan JB, Rager G, Escarment J, Pasquier P. Outcomes of COVID-19-Related ARDS Patients Hospitalized in a Military Field Intensive Care Unit. Mil Med 2021; 187:e1549-e1555. [PMID: 34195840 PMCID: PMC8344684 DOI: 10.1093/milmed/usab268] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/19/2021] [Accepted: 06/23/2021] [Indexed: 01/15/2023] Open
Abstract
Introduction Little evidence of outcome is available on critically ill Coronavirus Disease 2019 (COVID-19) patients hospitalized in a field hospital. Our purpose was to report outcomes of critically ill COVID-19 patients after hospitalization in a field intensive care unit (ICU), established under military tents in a civil–military collaboration. Methods All patients with COVID-19-related acute respiratory distress syndrome (ARDS) admitted to the Military Health Service Field Intensive Care Unit in Mulhouse (France) between March 24, 2020, and May 7, 2020, were included in the study. Medical history and clinical and laboratory data were collected prospectively. The institutional review board of the French Society Anesthesia and Intensive Care approved the study. Results Forty-seven patients were hospitalized (37 men, median age 62 [54-67] years, Sequential Organ Failure Assessment score 7 [6-10] points, and Simplified Acute Physiology Score II score 39 [28-50] points) during the 45-day deployment of the field ICU. Median length of stay was 11 [6-15] days and median length of ventilation was 13 [7.5-21] days. At the end of the deployment, 25 (53%) patients went back home, 17 (37%) were still hospitalized, and 4 (9%) died. At hospital discharge, 40 (85%) patients were alive. Conclusion In this study, a military field ICU joined a regional civil hospital to manage a large cluster of COVID-19-related ARDS patients in Mulhouse, France. This report illustrates how military teams can support civil authorities in the provision of advanced critical care. Outcomes of patient suggest that this field hospital deployment was an effective adaptation during pandemic conditions.
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Affiliation(s)
- Marc Danguy des Déserts
- Intensive Care, Anesthesia, Emergency and Operating Theatre Department, Clermont Tonnerre Military Training Hospital, Brest 29240, France.,EA3878 GETBO, University of Occidental Brittany, Brest 29238, France
| | - Quentin Mathais
- Intensive Care, Anesthesia, Burns and Operating Theatre Department, Sainte Anne Military Training Hospital, Toulon 83000, France
| | - Jean Baptiste Morvan
- Intensive Care, Anesthesia, Burns and Operating Theatre Department, Sainte Anne Military Training Hospital, Toulon 83000, France
| | - Gwendoline Rager
- Intensive Care, Anesthesia, Emergency and Operating Theatre Department, Robert Picqué Military Training Hospital, Villenave d'Ornon 33140, France
| | | | - Pierre Pasquier
- French Military Medical Academy, Paris 75005, France.,Intensive Care, Anesthesia, Burns and Operating Theatre Department, Percy Military Training Hospital, Clamart 92140, France
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30
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Luchini K, Sloan SNB, Mauro R, Sargsyan A, Newman A, Persaud P, Hawkins D, Wolff D, Staudinger J, Creamer BA. Sterilization and sanitizing of 3D-printed personal protective equipment using polypropylene and a Single Wall design. 3D Print Med 2021; 7:16. [PMID: 34115246 PMCID: PMC8193021 DOI: 10.1186/s41205-021-00106-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 05/30/2021] [Indexed: 12/29/2022] Open
Abstract
Background The emergence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic during the fall of 2019 and into the spring of 2020 has led to an increased demand of disposable N95 respirators and other types of personal protective equipment (PPE) as a way to prevent virus spread and help ensure the safety of healthcare workers. The sudden demand led to rapid modification, development, and dissemination of 3D printed PPE. The goal of this study was to determine the inherent sterility and re-sterilizing ability of 3D printed PPE in order to provide sterile equipment to the healthcare field and the general public. Methods Samples of polylactic acid (PLA), thermoplastic polyurethane (TPU) (infill-based designs) and polypropylene (single-wall hollow design) were 3D printed. Samples were inoculated with E. coli for 24 h and then sanitized using various chemical solutions or heat-based methods. The samples were then incubated for 24- or 72-h in sterile LB medium at 37°C, and bacterial growth was measured by optical density at 600nm. Statistical analysis was conducted using GraphPad Prism v8.2.1. Results Significant bacterial growth was observed in all PLA and TPU based samples following re-sterilization, regardless of the methods used when compared to controls (p < 0.05). The single-walled hollow polypropylene design was not only sterile following printing, but was also able to undergo re-sanitization following bacterial inoculation, with no significant bacterial growth (p > 0.05) observed regardless of sanitization method used. Conclusion The cost effectiveness, ease of sanitization, and reusability of 3D printed PPE, using our novel single-walled polypropylene design can help meet increased demands of PPE for healthcare workers and the general public that are needed to help decrease the viral transmission of the coronavirus disease of 2019 (COVID-19) pandemic. 3D printing also has the potential to lead to the creation and production of other sterile material items for the healthcare industry in the future. The ability to re-sterilize 3D printed PPE, as our design shows, would also contribute less to the increase in biomedical waste (BMW) being experienced by COVID-19. Supplementary Information The online version contains supplementary material available at 10.1186/s41205-021-00106-8.
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Affiliation(s)
- Karstan Luchini
- Department of Basic Sciences, Kansas City University, College of Medicine, Farber-McIntire Campus, Joplin, MO, USA
| | - Shelly N B Sloan
- Department of Basic Sciences, Kansas City University, College of Medicine, Farber-McIntire Campus, Joplin, MO, USA.,Department of Biology and Environmental Health, Missouri Southern State University, Joplin, MO, USA
| | - Ryan Mauro
- Department of Basic Sciences, Kansas City University, College of Medicine, Farber-McIntire Campus, Joplin, MO, USA
| | - Aspram Sargsyan
- Department of Basic Sciences, Kansas City University, College of Medicine, Farber-McIntire Campus, Joplin, MO, USA
| | - Aundrea Newman
- Department of Basic Sciences, Kansas City University, College of Medicine, Farber-McIntire Campus, Joplin, MO, USA
| | - Purnadeo Persaud
- Department of Basic Sciences, Kansas City University, College of Medicine, Farber-McIntire Campus, Joplin, MO, USA
| | | | - Dennis Wolff
- Department of Basic Sciences, Kansas City University, College of Medicine, Farber-McIntire Campus, Joplin, MO, USA.,Department of Biology and Environmental Health, Missouri Southern State University, Joplin, MO, USA
| | - Jeff Staudinger
- Department of Basic Sciences, Kansas City University, College of Medicine, Farber-McIntire Campus, Joplin, MO, USA.,Department of Biology and Environmental Health, Missouri Southern State University, Joplin, MO, USA
| | - Bradley A Creamer
- Department of Basic Sciences, Kansas City University, College of Medicine, Farber-McIntire Campus, Joplin, MO, USA. .,Department of Biology and Environmental Health, Missouri Southern State University, Joplin, MO, USA.
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31
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Hossain L, Maliha M, Barajas-Ledesma R, Kim J, Putera K, Subedi D, Tanner J, Barr JJ, Banaszak Holl MM, Garnier G. Engineering laminated paper for SARS-CoV-2 medical gowns. POLYMER 2021; 222:123643. [PMID: 33758430 PMCID: PMC7975575 DOI: 10.1016/j.polymer.2021.123643] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 03/03/2021] [Accepted: 03/12/2021] [Indexed: 02/04/2023]
Abstract
The COVID-19 pandemic has highlighted the need for diversity in the market and alternative materials for personal protective equipment (PPE). Paper has high coatability for tunable barrier performance, and an agile production process, making it a potential substitute for polyolefin-derived PPE materials. Bleached and newsprint papers were laminated with polyethylene (PE) coatings of different thicknesses, and characterised for their potential use as medical gowns for healthcare workers and COVID-19 patients. Thicker PE lamination improved coating homogeneity and water vapour resistance. 49 GSM bleached paper with 16 GSM PE coating showed high tensile and seam strength, and low water vapour transmission rate (WVTR). Phi-X174 bacteriophage testing revealed that paper laminated with 15 GSM coating hinders virus penetration. This research demonstrates that PE laminated paper is a promising material for low cost viral protective gowns.
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Affiliation(s)
- Laila Hossain
- Bioresource Processing Research Institute of Australia (BioPRIA), Australia
- Department of Chemical Engineering, Monash University, VIC, 3800, Australia
| | - Maisha Maliha
- Bioresource Processing Research Institute of Australia (BioPRIA), Australia
- Department of Chemical Engineering, Monash University, VIC, 3800, Australia
| | - Ruth Barajas-Ledesma
- Bioresource Processing Research Institute of Australia (BioPRIA), Australia
- Department of Chemical Engineering, Monash University, VIC, 3800, Australia
| | - Jinhee Kim
- Department of Chemical Engineering, Monash University, VIC, 3800, Australia
| | - Kevin Putera
- Department of Chemical Engineering, Monash University, VIC, 3800, Australia
| | - Dinesh Subedi
- School of Biological Sciences, Monash University, VIC, 3800, Australia
| | - Joanne Tanner
- Bioresource Processing Research Institute of Australia (BioPRIA), Australia
- Department of Chemical Engineering, Monash University, VIC, 3800, Australia
| | - Jeremy J Barr
- School of Biological Sciences, Monash University, VIC, 3800, Australia
| | | | - Gil Garnier
- Bioresource Processing Research Institute of Australia (BioPRIA), Australia
- Department of Chemical Engineering, Monash University, VIC, 3800, Australia
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32
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Boffetta P, Violante F, Durando P, De Palma G, Pira E, Vimercati L, Cristaudo A, Icardi G, Sala E, Coggiola M, Tafuri S, Gattini V, Apostoli P, Spatari G. Determinants of SARS-CoV-2 infection in Italian healthcare workers: a multicenter study. Sci Rep 2021; 11:5788. [PMID: 33707646 PMCID: PMC7970984 DOI: 10.1038/s41598-021-85215-4] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 01/27/2021] [Indexed: 12/23/2022] Open
Abstract
Healthcare workers (HCWs) are at increased risk of being infected with SARS-CoV-2, yet limited information is available on risk factors of infection. We pooled data on occupational surveillance of 10,654 HCW who were tested for SARS-CoV-2 infection in six Italian centers. Information was available on demographics, job title, department of employment, source of exposure, use of personal protective equipment (PPEs), and COVID-19-related symptoms. We fitted multivariable logistic regression models to calculate odds ratios and 95% confidence intervals of infection. The prevalence of infection ranged from 3.0 to 22.0%, and was correlated with that of the respective areas. Women were at lower risk of infection compared to men. Fever, cough, dyspnea and malaise were the symptoms most strongly associated with infection, together with anosmia and ageusia. No differences in the risk of infection were detected according to job title, or working in a COVID-19 designated department. Reported contact with a patient inside or outside the workplace was a risk factor. Use of a mask was strongly protective against risk of infection as was use of gloves. The use of a mask by the source of exposure (patient or colleague) had an independent effect in reducing infection risk.
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Affiliation(s)
- Paolo Boffetta
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY, USA. .,Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
| | - Francesco Violante
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Paolo Durando
- Department of Health Sciences, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Giuseppe De Palma
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Enrico Pira
- Department of Public Health and Pediatric Sciences, University of Turin, Turin, Italy
| | - Luigi Vimercati
- Interdisciplinary Department of Medicine, University of Bari, Bari, Italy
| | - Alfonso Cristaudo
- University Hospital Pisana, Pisa, Italy.,University of Pisa, Pisa, Italy
| | - Giancarlo Icardi
- Department of Health Sciences, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Emma Sala
- University Hospital Spedali Civili di Brescia, Brescia, Italy
| | - Maurizio Coggiola
- University Hospital City of Health and Science of Turin, Turin, Italy
| | - Silvio Tafuri
- Interdisciplinary Department of Medicine, University of Bari, Bari, Italy
| | - Vittorio Gattini
- University Hospital Pisana, Pisa, Italy.,University of Pisa, Pisa, Italy
| | - Pietro Apostoli
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.,Italian Society of Occupational Medicine, Bologna, Italy
| | - Giovanna Spatari
- Department of Biomedical and Dentistry Sciences and Morphological and Functional Imaging, University of Messina, Messina, Italy
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Ashinyo ME, Dubik SD, Duti V, Amegah KE, Ashinyo A, Asare BA, Ackon AA, Akoriyea SK, Kuma-Aboagye P. Infection prevention and control compliance among exposed healthcare workers in COVID-19 treatment centers in Ghana: A descriptive cross-sectional study. PLoS One 2021; 16:e0248282. [PMID: 33690699 PMCID: PMC7943010 DOI: 10.1371/journal.pone.0248282] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 02/24/2021] [Indexed: 02/07/2023] Open
Abstract
Compliance with infection prevention and control (IPC) protocols is critical in minimizing the risk of coronavirus disease (COVID-19) infection among healthcare workers. However, data on IPC compliance among healthcare workers in COVID-19 treatment centers are unknown in Ghana. This study aims to assess IPC compliance among healthcare workers in Ghana's COVID-19 treatment centers. The study was a secondary analysis of data, which was initially collected to determine the level of risk of COVID-19 virus infection among healthcare workers in Ghana. Quantitative data were conveniently collected using the WHO COVID-19 risk assessment tool. We analyzed the data using descriptive statistics and logistic regression analyses. We observed that IPC compliance during healthcare interactions was 88.4% for hand hygiene and 90.6% for Personal Protective Equipment (PPE) usage; IPC compliance while performing aerosol-generating procedures (AGPs), was 97.5% for hand hygiene and 97.5% for PPE usage. For hand hygiene during healthcare interactions, lower compliance was seen among nonclinical staff [OR (odds ratio): 0.43; 95% CI (Confidence interval): 0.21-0.89], and healthcare workers with secondary level qualification (OR: 0.24; 95% CI: 0.08-0.71). Midwives (OR: 0.29; 95% CI: 0.09-0.93) and Pharmacists (OR: 0.15; 95% CI: 0.02-0.92) compliance with hand hygiene was significantly lower than registered nurses. For PPE usage during healthcare interactions, lower compliance was seen among healthcare workers who were separated/divorced/widowed (OR: 0.08; 95% CI: 0.01-0.43), those with secondary level qualifications (OR 0.08; 95% CI 0.01-0.43), non-clinical staff (OR 0.16 95% CI 0.07-0.35), cleaners (OR: 0.16; 95% CI: 0.05-0.52), pharmacists (OR: 0.07; 95% CI: 0.01-0.49) and among healthcare workers who reported of insufficiency of PPEs (OR: 0.33; 95% CI: 0.14-0.77). Generally, healthcare workers' infection prevention and control compliance were high, but this compliance differs across the different groups of health professionals in the treatment centers. Ensuring an adequate supply of IPC logistics coupled with behavior change interventions and paying particular attention to nonclinical staff is critical in minimizing the risk of COVID-19 transmission in the treatment centers.
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Affiliation(s)
- Mary Eyram Ashinyo
- Institutional Care Division, Ghana Health Service Headquarters, Accra, Ghana
| | - Stephen Dajaan Dubik
- School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
| | - Vida Duti
- IRC-Ghana, Cantonments, Accra, Ghana
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Kua J, Patel R, Nurmi E, Tian S, Gill H, Wong DJN, Moorley C, Nepogodiev D, Ahmad I, El-Boghdadly K. healthcareCOVID: a national cross-sectional observational study identifying risk factors for developing suspected or confirmed COVID-19 in UK healthcare workers. PeerJ 2021; 9:e10891. [PMID: 33604201 PMCID: PMC7868068 DOI: 10.7717/peerj.10891] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 01/12/2021] [Indexed: 11/20/2022] Open
Abstract
Objective To establish the prevalence, risk factors and implications of suspected or confirmed coronavirus disease 2019 (COVID-19) infection among healthcare workers in the United Kingdom (UK). Design Cross-sectional observational study. Setting UK-based primary and secondary care. Participants Healthcare workers aged ≥18 years working between 1 February and 25 May 2020. Main outcome measures A composite endpoint of laboratory-confirmed diagnosis of SARS-CoV-2, or self-isolation or hospitalisation due to suspected or confirmed COVID-19. Results Of 6,152 eligible responses, the composite endpoint was present in 1,806 (29.4%) healthcare workers, of whom 49 (0.8%) were hospitalised, 459 (7.5%) tested positive for SARS-CoV-2, and 1,776 (28.9%) reported self-isolation. Overall, between 11,870 and 21,158 days of self-isolation were required by the cohort, equalling approximately 71 to 127 working days lost per 1,000 working days. The strongest risk factor associated with the presence of the primary composite endpoint was increasing frequency of contact with suspected or confirmed COVID-19 cases without adequate personal protective equipment (PPE): 'Never' (reference), 'Rarely' (adjusted odds ratio 1.06, (95% confidence interval: [0.87-1.29])), 'Sometimes' (1.7 [1.37-2.10]), 'Often' (1.84 [1.28-2.63]), 'Always' (2.93, [1.75-5.06]). Additionally, several comorbidities (cancer, respiratory disease, and obesity); working in a 'doctors' role; using public transportation for work; regular contact with suspected or confirmed COVID-19 patients; and lack of PPE were also associated with the presence of the primary endpoint. A total of 1,382 (22.5%) healthcare workers reported lacking access to PPE items while having clinical contact with suspected or confirmed COVID-19 cases. Conclusions Suspected or confirmed COVID-19 was more common in healthcare workers than in the general population and is associated with significant workforce implications. Risk factors included inadequate PPE, which was reported by nearly a quarter of healthcare workers. Governments and policymakers must ensure adequate PPE is available as well as developing strategies to mitigate risk for high-risk healthcare workers during future COVID-19 waves.
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Affiliation(s)
- Justin Kua
- Department of Targeted Intervention, Centre for Perioperative Medicine, UCL Division of Surgery and Interventional Science, University College London, University of London, London, United Kingdom.,Health Services Research Centre, National Institute of Academic Anaesthesia, Royal College of Anaesthetists, London, UK
| | - Reshma Patel
- Department of Targeted Intervention, Centre for Perioperative Medicine, UCL Division of Surgery and Interventional Science, University College London, University of London, London, United Kingdom.,Health Services Research Centre, National Institute of Academic Anaesthesia, Royal College of Anaesthetists, London, UK
| | - Eveliina Nurmi
- Department of Anaesthesia, University College London Hospitals NHS Foundation Trust, London, UK
| | - Sarah Tian
- Department of Anaesthesia, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Harpreet Gill
- Department of Anaesthesia, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Danny J N Wong
- Health Services Research Centre, National Institute of Academic Anaesthesia, Royal College of Anaesthetists, London, UK.,Department of Anaesthesia, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Calvin Moorley
- School of Health and Social Care/Adult Nursing & Midwifery Studies, London South Bank University, London, UK
| | - Dmitri Nepogodiev
- National Institute for Health Research Global Health Research Unit on Global Surgery, University of Birmingham, Birmingham, UK
| | - Imran Ahmad
- Department of Anaesthesia, Guy's and St Thomas' NHS Foundation Trust, London, UK.,King's College London, University of London, London, UK
| | - Kariem El-Boghdadly
- Department of Anaesthesia, Guy's and St Thomas' NHS Foundation Trust, London, UK.,King's College London, University of London, London, UK
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Alvino RT, Caughell CM. COVID-19 in the Perioperative Setting: Applying a Hierarchy of Controls to Prevent Transmission. AORN J 2021; 113:147-164. [PMID: 33534156 PMCID: PMC8013826 DOI: 10.1002/aorn.13301] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 09/11/2020] [Accepted: 09/18/2020] [Indexed: 12/20/2022]
Abstract
The evolution of SARS-CoV-2 from a zoonotic virus to a novel human pathogen resulted in the coronavirus disease 2019 (COVID-19) global pandemic. Health care delivery and infection prevention and control recommendations continue to evolve to protect the safety of health care personnel, patients, and visitors while researchers and policymakers learn more about SARS-CoV-2 and COVID-19. The perioperative setting is unique in that it exposes clinicians and personnel to increased risks through the invasive nature of surgical care. Using the Centers for Disease Control and Prevention's Hierarchy of Controls as a model, this article presents risk mitigation strategies for preventing the transmission of COVID-19 in the perioperative environment. The goals are to identify and eliminate potential exposure to SARS-CoV-2 when surgery is necessary for patients who are suspected or confirmed to have COVID-19 or who have an unknown infection status.
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Piccoli L, Ferrari P, Piumatti G, Jovic S, Rodriguez BF, Mele F, Giacchetto-Sasselli I, Terrot T, Silacci-Fregni C, Cameroni E, Jaconi S, Sprugasci N, Bartha I, Corti D, Uguccioni M, Lanzavecchia A, Garzoni C, Giannini O, Bernasconi E, Elzi L, Albanese E, Sallusto F, Ceschi A. Risk assessment and seroprevalence of SARS-CoV-2 infection in healthcare workers of COVID-19 and non-COVID-19 hospitals in Southern Switzerland. THE LANCET REGIONAL HEALTH. EUROPE 2021; 1:100013. [PMID: 34173621 PMCID: PMC7833818 DOI: 10.1016/j.lanepe.2020.100013] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Hospital healthcare workers (HCW), in particular those involved in the clinical care of COVID-19 cases, are presumably exposed to a higher risk of acquiring the disease than the general population. METHODS Between April 16 and 30, 2020 we conducted a prospective, SARS-CoV-2 seroprevalence study in HCWs in Southern Switzerland. Participants were hospital personnel with varying COVID-19 exposure risk depending on job function and working site. They provided personal information (including age, sex, occupation, and medical history) and self-reported COVID-19 symptoms. Odds ratio (OR) of seropositivity to IgG antibodies was estimated by univariate and multivariate logistic regressions. FINDINGS Among 4726 participants, IgG antibodies to SARS-CoV-2 were detected in 9.6% of the HCWs. Seropositivity was higher among HCWs working on COVID-19 wards (14.1% (11.9-16.5)) compared to other hospital areas at medium (10.7% (7.6-14.6)) or low risk exposure (7.3% (6.4-8.3)). OR for high vs. medium wards risk exposure was 1.42 (0.91-2.22), P = 0.119, and 1.98 (1.55-2.53), P<0.001 for high vs. low wards risk exposure. The same was for true for doctors and nurses (10.1% (9.0-11.3)) compared to other employees at medium (7.1% (4.8-10.0)) or low risk exposure (6.6% (5.0-8.4)). OR for high vs. medium profession risk exposure was 1.37 (0.89-2.11), P = 0.149, and 1.75 (1.28-2.40), P = 0.001 for high vs. low profession risk exposure. Moreover, seropositivity was higher among HCWs who had household exposure to COVID-19 cases compared to those without (18.7% (15.3-22.5) vs. 7.7% (6.9-8.6), OR 2.80 (2.14-3.67), P<0.001). INTERPRETATION SARS-CoV-2 antibodies are detectable in up to 10% of HCWs from acute care hospitals in a region with high incidence of COVID-19 in the weeks preceding the study. HCWs with exposure to COVID-19 patients have only a slightly higher absolute risk of seropositivity compared to those without, suggesting that the use of PPE and other measures aiming at reducing nosocomial viral transmission are effective. Household contact with known COVID-19 cases represents the highest risk of seropositivity. FUNDING Henry Krenter Foundation, Ente Ospedaliero Cantonale and Vir Biotechnology.
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Affiliation(s)
- Luca Piccoli
- Humabs BioMed SA, A Subsidiary of Vir Biotechnology, Bellinzona, Switzerland
| | - Paolo Ferrari
- Department of Internal Medicine, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
- Clinical School, University of New South Wales, Sydney, Australia
| | - Giovanni Piumatti
- Division of Primary Care, Population Epidemiology Unit, Geneva University Hospitals, Geneva, Switzerland
- nstitute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Sandra Jovic
- Institute for Research in Biomedicine, Bellinzona, Università della Svizzera italiana, Bellinzona, Switzerland
| | - Blanca Fernandez Rodriguez
- Institute for Research in Biomedicine, Bellinzona, Università della Svizzera italiana, Bellinzona, Switzerland
| | - Federico Mele
- Institute for Research in Biomedicine, Bellinzona, Università della Svizzera italiana, Bellinzona, Switzerland
| | | | - Tatiana Terrot
- Clinical Trial Unit, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | | | - Elisabetta Cameroni
- Humabs BioMed SA, A Subsidiary of Vir Biotechnology, Bellinzona, Switzerland
| | - Stefano Jaconi
- Humabs BioMed SA, A Subsidiary of Vir Biotechnology, Bellinzona, Switzerland
| | - Nicole Sprugasci
- Humabs BioMed SA, A Subsidiary of Vir Biotechnology, Bellinzona, Switzerland
| | - Istvan Bartha
- Humabs BioMed SA, A Subsidiary of Vir Biotechnology, Bellinzona, Switzerland
| | - Davide Corti
- Humabs BioMed SA, A Subsidiary of Vir Biotechnology, Bellinzona, Switzerland
| | - Mariagrazia Uguccioni
- Institute for Research in Biomedicine, Bellinzona, Università della Svizzera italiana, Bellinzona, Switzerland
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (Milan), Italy
| | - Antonio Lanzavecchia
- Institute for Research in Biomedicine, Bellinzona, Università della Svizzera italiana, Bellinzona, Switzerland
| | - Christian Garzoni
- Clinic of Internal Medicine and Infectious Diseases, Clinica Luganese Moncucco, Lugano, Switzerland
- Department of Infectious Diseases, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Olivier Giannini
- Department of Internal Medicine, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
| | - Enos Bernasconi
- Department of Internal Medicine, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
| | - Luigia Elzi
- Department of Internal Medicine, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
| | - Emiliano Albanese
- nstitute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Federica Sallusto
- Institute for Research in Biomedicine, Bellinzona, Università della Svizzera italiana, Bellinzona, Switzerland
- Institute of Microbiology, ETH Zurich, Zurich, Switzerland
| | - Alessandro Ceschi
- Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
- Clinical Trial Unit, Ente Ospedaliero Cantonale, Lugano, Switzerland
- Division of Clinical Pharmacology and Toxicology, Institute of Pharmacological Sciences of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland
- Department of Clinical Pharmacology and Toxicology, University Hospital Zurich, Zurich, Switzerland
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Agrawal V, Yadav SK, Agarwal P, Sharma D. Strategies for Optimizing the Use of PPE During Surgery in COVID-19 Pandemic: Rapid Scoping Review of Guidelines. Indian J Surg 2021; 83:17-27. [PMID: 33424182 PMCID: PMC7785932 DOI: 10.1007/s12262-020-02713-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 12/30/2020] [Indexed: 12/30/2022] Open
Abstract
Personal protective equipment (PPE) plays a fundamental role in the prevention of spread to Health Care Professionals (HCP) ; especially in a surgical setting. This scoping review of surgery guidelines was performed to appraise the quality of appropriate PPE recommendations and propose a strategy to optimize the PPE usage. This rapid scoping review of guidelines on surgery during COVID-19 was conducted according to Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews protocol. Important databases were searched from January 1, 2020 to July 31, 2020, for relevant studies produced by a national/international academic association/organization, in English literature, using relevant keywords. Quality of evidence was graded according to GRADE guidelines. The searches yielded a total of 1725 studies, out of these 41 guidelines on surgery during COVID-19 matching with pre-defined criteria were evaluated. The level of evidence was uniformly rated "low," as assessed by GRADE guidelines and recommendations provided by them were mostly non-specific covering a narrow range of items. The crucial issue of optimization of PPE was not addressed at all. Economic implications demand optimization of PPE and conservation of resources. A simple decision-making algorithm addressing all the limitations of guidelines can be constructed, which allows HCPs to safeguard themselves and at the same time optimize/ conserving resources.
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Affiliation(s)
- Vikesh Agrawal
- Pediatric Surgery Division, Department of Surgery, Netaji Subhash Chandra Bose Government Medical College, Nagpur Road, Jabalpur, 482002 India
| | - Sanjay Kumar Yadav
- Pediatric Surgery Division, Department of Surgery, Netaji Subhash Chandra Bose Government Medical College, Nagpur Road, Jabalpur, 482002 India
| | - Pawan Agarwal
- Pediatric Surgery Division, Department of Surgery, Netaji Subhash Chandra Bose Government Medical College, Nagpur Road, Jabalpur, 482002 India
| | - Dhananjaya Sharma
- Pediatric Surgery Division, Department of Surgery, Netaji Subhash Chandra Bose Government Medical College, Nagpur Road, Jabalpur, 482002 India
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Galicia JC, Mungia R, Taverna MV, Mendoza MJ, Estrela C, Gaudin A, Zhang C, Vaughn BA, Khan AA. Response by Endodontists to the SARS-CoV-2 (COVID−19) Pandemic: An International Survey. FRONTIERS IN DENTAL MEDICINE 2021. [DOI: 10.3389/fdmed.2020.617440] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
As SARS-CoV-2 continues to wreak havoc, health care workers are on the front lines to protect our communities. Dentists, particularly endodontists who manage dental emergencies, are engaged in high risk procedures that necessitate the modification of their treatment strategies in order to protect themselves, their staff and their patients from exposure to SARS-CoV-2. This study gathered international data from 448 endodontists to describe their awareness, their clinical care modifications, their strategies for re-opening and their reflection on the effects of the pandemic on their lives. Most endodontic practitioners (78%, n = 350) provided but limited their treatments to emergency care during the government-mandated shutdowns. They agreed with their local government's actions more than that of the national government, screened their patients for symptoms prior to treatment and changed their clinical care protocol to mitigate the spread of the virus. The pandemic has impacted their income, their ability to retain staff, and their financial and personal outlook in life.
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Abstract
The COVID-19 pandemic poses many direct and indirect consequences for children's health and associated research. Direct consequences include participation of children in COVID-19 research trials, pausing other research in children and the potential implications of a global economic downturn on future research funding. Collaborative and networked research together with streamlined research processes and use of remote technology have been central to efforts by clinicians and scientists around the world and have proved essential for reducing COVID-19 morbidity and mortality. IMPACT: Maintain streamlined and efficient approaches to research governance and data sharing to facilitate high-quality collaborative research. Ensure early inclusion of children in trials of therapies for diseases that affect all age groups. Paediatric Research Societies should co-ordinate effective processes to define key research questions and develop multinational clinical trials for diagnostics, therapeutics and preventative strategies for infants, children and young people.
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Aumeran C, Henquell C, Brebion A, Noureddine J, Traore O, Lesens O. Isolation gown contamination during healthcare of confirmed SARS-CoV-2-infected patients. J Hosp Infect 2021; 107:111-113. [PMID: 33188869 PMCID: PMC7657029 DOI: 10.1016/j.jhin.2020.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 11/06/2020] [Accepted: 11/06/2020] [Indexed: 12/31/2022]
Affiliation(s)
- C Aumeran
- Infection Control Department, 3IHP, CHU, Clermont-Ferrand, France; Université Clermont Auvergne UMR, CNRS 6023, Laboratoire Microorganismes: Génome Environnement (LMGE), Clermont-Ferrand, France.
| | - C Henquell
- Université Clermont Auvergne UMR, CNRS 6023, Laboratoire Microorganismes: Génome Environnement (LMGE), Clermont-Ferrand, France; Virology Department, 3IHP, CHU, Clermont-Ferrand, France
| | - A Brebion
- Université Clermont Auvergne UMR, CNRS 6023, Laboratoire Microorganismes: Génome Environnement (LMGE), Clermont-Ferrand, France; Virology Department, 3IHP, CHU, Clermont-Ferrand, France
| | - J Noureddine
- Université Clermont Auvergne UMR, CNRS 6023, Laboratoire Microorganismes: Génome Environnement (LMGE), Clermont-Ferrand, France; Infectious and Tropical Diseases Department, CRIOA, 3IHP, CHU, Clermont-Ferrand, France
| | - O Traore
- Infection Control Department, 3IHP, CHU, Clermont-Ferrand, France; Université Clermont Auvergne UMR, CNRS 6023, Laboratoire Microorganismes: Génome Environnement (LMGE), Clermont-Ferrand, France
| | - O Lesens
- Université Clermont Auvergne UMR, CNRS 6023, Laboratoire Microorganismes: Génome Environnement (LMGE), Clermont-Ferrand, France; Infectious and Tropical Diseases Department, CRIOA, 3IHP, CHU, Clermont-Ferrand, France
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Majumder MAA, Rahman S, Cohall D, Bharatha A, Singh K, Haque M, Gittens-St Hilaire M. Antimicrobial Stewardship: Fighting Antimicrobial Resistance and Protecting Global Public Health. Infect Drug Resist 2020; 13:4713-4738. [PMID: 33402841 PMCID: PMC7778387 DOI: 10.2147/idr.s290835] [Citation(s) in RCA: 197] [Impact Index Per Article: 49.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 12/17/2020] [Indexed: 12/18/2022] Open
Abstract
Antimicrobial resistance (AMR) is a serious threat to global public health. It increases morbidity and mortality, and is associated with high economic costs due to its health care burden. Infections with multidrug-resistant (MDR) bacteria also have substantial implications on clinical and economic outcomes. Moreover, increased indiscriminate use of antibiotics during the COVID-19 pandemic will heighten bacterial resistance and ultimately lead to more deaths. This review highlights AMR's scale and consequences, the importance, and implications of an antimicrobial stewardship program (ASP) to fight resistance and protect global health. Antimicrobial stewardship (AMS), an organizational or system-wide health-care strategy, is designed to promote, improve, monitor, and evaluate the rational use of antimicrobials to preserve their future effectiveness, along with the promotion and protection of public health. ASP has been very successful in promoting antimicrobials' appropriate use by implementing evidence-based interventions. The "One Health" approach, a holistic and multisectoral approach, is also needed to address AMR's rising threat. AMS practices, principles, and interventions are critical steps towards containing and mitigating AMR. Evidence-based policies must guide the "One Health" approach, vaccination protocols, health professionals' education, and the public's awareness about AMR.
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Affiliation(s)
- Md Anwarul Azim Majumder
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
| | - Sayeeda Rahman
- School of Medicine, American University of Integrative Sciences, Bridgetown, Barbados
| | - Damian Cohall
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
| | - Ambadasu Bharatha
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
| | - Keerti Singh
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
| | - Mainul Haque
- Faculty of Medicine and Defence Health, Universiti Pertahanan, Nasional Malaysia (National Defence University of Malaysia), Kuala Lumpur, Malaysia
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Inglis R, Barros L, Checkley W, Cizmeci EA, Lelei-Mailu F, Pattnaik R, Papali A, Schultz MJ, Ferreira JC. Pragmatic Recommendations for Safety while Caring for Hospitalized Patients with COVID-19 in Low- and Middle-Income Countries. Am J Trop Med Hyg 2020; 104:12-24. [PMID: 33355072 PMCID: PMC7957241 DOI: 10.4269/ajtmh.20-1128] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 12/06/2020] [Indexed: 11/07/2022] Open
Abstract
Infection prevention and control measures to control the spread of COVID-19 are challenging to implement in many low- and middle-income countries (LMICs). This is compounded by the fact that most recommendations are based on evidence that mainly originates in high-income countries. There are often availability, affordability, and feasibility barriers to applying such recommendations in LMICs, and therefore, there is a need for developing recommendations that are achievable in LMICs. We used a modified version of the GRADE method to select important questions, searched the literature for relevant evidence, and formulated pragmatic recommendations for safety while caring for patients with COVID-19 in LMICs. We selected five questions related to safety, covering minimal requirements for personal protective equipment (PPE), recommendations for extended use and reuse of PPE, restriction on the number of times healthcare workers enter patients' rooms, hand hygiene, and environmental ventilation. We formulated 21 recommendations that are feasible and affordable in LMICs.
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Affiliation(s)
- Rebecca Inglis
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Mahosot Hospital, Vientiane, Lao People’s Democratic Republic
| | - Lia Barros
- Division of Cardiology, University of Washington, Seattle, Washington
| | - William Checkley
- Division of Pulmonary and Critical Care, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland
- Center for Global Non-Communicable Disease Research and Training, School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Elif A. Cizmeci
- Interdepartmental Division of Critical Care Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
| | - Faith Lelei-Mailu
- Department of Quality Health and Safety, AIC Kijabe Hospital, Kijabe, Kenya
| | | | - Alfred Papali
- Division of Pulmonary and Critical Care Medicine, Atrium Health, Charlotte, North Carolina
| | - Marcus J. Schultz
- Department of Intensive Care, Amsterdam University Medical Centers, Amsterdam, The Netherlands
- Department of Clinical Tropical Medicine, Mahidol University, Bangkok, Thailand
- Mahidol–Oxford Tropical Medicine Research Unit (MORU), Mahidol University, Bangkok, Thailand
| | - Juliana C. Ferreira
- Divisao de Pneumologia, Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - for the COVID-LMIC Task Force and the Mahidol-Oxford Research Unit (MORU)
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Mahosot Hospital, Vientiane, Lao People’s Democratic Republic
- Division of Cardiology, University of Washington, Seattle, Washington
- Division of Pulmonary and Critical Care, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland
- Center for Global Non-Communicable Disease Research and Training, School of Medicine, Johns Hopkins University, Baltimore, Maryland
- Interdepartmental Division of Critical Care Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
- Department of Quality Health and Safety, AIC Kijabe Hospital, Kijabe, Kenya
- Division of Critical Care Medicine, Ispat General Hospital, Rourkela, India
- Division of Pulmonary and Critical Care Medicine, Atrium Health, Charlotte, North Carolina
- Department of Intensive Care, Amsterdam University Medical Centers, Amsterdam, The Netherlands
- Department of Clinical Tropical Medicine, Mahidol University, Bangkok, Thailand
- Mahidol–Oxford Tropical Medicine Research Unit (MORU), Mahidol University, Bangkok, Thailand
- Divisao de Pneumologia, Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
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Querney J, Cubillos J, Ding Y, Cherry R, Armstrong K. Patient barrier acceptance during airway management among anesthesiologists: a simulation pilot study. Korean J Anesthesiol 2020; 74:254-261. [PMID: 33285048 PMCID: PMC8175886 DOI: 10.4097/kja.20464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 12/01/2020] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Protection of healthcare providers (HCP) has been a serious challenge in the management of patients during the coronavirus 2019 (COVID-19) pandemic. Additional physical barriers have been created to enhance personal protective equipment (PPE). In this study, user acceptability of two novel barriers was evaluated and the performance of airway management using PPE alone versus PPE plus the additional barrier were compared. METHODS An open-label, double-armed simulation pilot study was conducted. Each participant performed bag-mask ventilation and endotracheal intubation using a GlideScope in two scenarios: 1) PPE donned, followed by 2) PPE donned plus the addition of either the isolation chamber (IC) or aerosol box (AB). Endotracheal intubation using videolaryngoscopy was timed. Participants completed pre- and post-simulation questionnaires. RESULTS Twenty-nine participants from the Department of Anesthesia were included in the study. Pre- and post-simulation questionnaire responses supported the acceptance of additional barriers. There was no significant difference in intubating times across all groups (PPE vs. IC 95% CI, 26.3, 35.1; PPE vs. AB 95% CI, 25.9, 35.5; IC vs. AB 95% CI, 23.6, 39.1). Comparison of post-simulation questionnaire responses between IC and AB showed no significant difference. Participants did not find the additional barriers negatively affected communication, visualization, or maneuverability. CONCLUSIONS Overall, the IC and AB were comparable, and there was no negative impact on performance under testing conditions. Our study suggests the positive acceptance of additional patient protection barriers by anesthesia providers during airway management.
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Affiliation(s)
- Jill Querney
- Department of Anesthesia & Perioperative Medicine, Western University, London, Canada.,Schulich School of Medicine & Dentistry, Western University, London, Canada
| | - Javier Cubillos
- Department of Anesthesia & Perioperative Medicine, Western University, London, Canada.,Schulich School of Medicine & Dentistry, Western University, London, Canada
| | - Youshan Ding
- Schulich School of Medicine & Dentistry, Western University, London, Canada
| | - Richard Cherry
- Department of Anesthesia & Perioperative Medicine, Western University, London, Canada.,Schulich School of Medicine & Dentistry, Western University, London, Canada
| | - Kevin Armstrong
- Department of Anesthesia & Perioperative Medicine, Western University, London, Canada.,Schulich School of Medicine & Dentistry, Western University, London, Canada
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Zhan M, Anders RL, Lin B, Zhang M, Chen X. Lesson learned from China regarding use of personal protective equipment. Am J Infect Control 2020. [PMID: 32791259 DOI: 10.1016/j.ajic.2020.08.00] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND In Wuhan, China, in December 2019, the novel coronavirus was detected. The virus causing COVID-19 was related to a coronavirus named severe acute respiratory syndrome coronavirus (SARS-CoV). The virus caused an epidemic in China and was quickly contained in 2003. Although coming from the same family of viruses and sharing certain transmissibility factors, the local health institutions in China had no experience with this new virus, subsequently named SARS-CoV-2. METHODS Based on their prior experience with the 2003 SARS epidemic, health authorities in China recognized the need for personal protective equipment (PPE). Existing PPE and protocols were limited and reflected early experience with SARS; however, as additional PPE supplies became available, designated COVID-19 hospitals in Hubei Province adopted the World Health Organization guidelines for Ebola to create a protocol specific for treating patients with COVID-19. RESULTS This article describes the PPE and protocol for its safe and effective deployment and the implementation of designated hospital units for COVID-19 patients. To date, only 2 nurses working in China who contracted SARS-CoV-2 have died from COVID-19 in the early period of the epidemic (February 11 and 14, 2020). CONCLUSIONS The lessons learned by health care workers in China are shared in the hope of preventing future occupational exposure.
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Affiliation(s)
- Mingkun Zhan
- Department of Plastic Surgery, Fujian Medical University Union Hospital, Fujian Medical University, Fuzhou, China
| | - Robert L Anders
- School of Nursing, University of Texas at El Paso, El Paso, TX, USA.
| | - Bihua Lin
- Department of Plastic Surgery, Fujian Medical University Union Hospital, Fujian Medical University, Fuzhou, China
| | - Min Zhang
- Department of Pharmacy, Boston Medical Center, Boston, MA, USA
| | - Xiaosong Chen
- Department of Plastic Surgery, Fujian Medical University Union Hospital, Fujian Medical University, Fuzhou, China
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45
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Zhan M, Anders RL, Lin B, Zhang M, Chen X. Lesson learned from China regarding use of personal protective equipment. Am J Infect Control 2020; 48:1462-1465. [PMID: 32791259 PMCID: PMC7417913 DOI: 10.1016/j.ajic.2020.08.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 08/04/2020] [Accepted: 08/05/2020] [Indexed: 11/26/2022]
Abstract
Background In Wuhan, China, in December 2019, the novel coronavirus was detected. The virus causing COVID-19 was related to a coronavirus named severe acute respiratory syndrome coronavirus (SARS-CoV). The virus caused an epidemic in China and was quickly contained in 2003. Although coming from the same family of viruses and sharing certain transmissibility factors, the local health institutions in China had no experience with this new virus, subsequently named SARS-CoV-2. Methods Based on their prior experience with the 2003 SARS epidemic, health authorities in China recognized the need for personal protective equipment (PPE). Existing PPE and protocols were limited and reflected early experience with SARS; however, as additional PPE supplies became available, designated COVID-19 hospitals in Hubei Province adopted the World Health Organization guidelines for Ebola to create a protocol specific for treating patients with COVID-19. Results This article describes the PPE and protocol for its safe and effective deployment and the implementation of designated hospital units for COVID-19 patients. To date, only 2 nurses working in China who contracted SARS-CoV-2 have died from COVID-19 in the early period of the epidemic (February 11 and 14, 2020). Conclusions The lessons learned by health care workers in China are shared in the hope of preventing future occupational exposure.
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Affiliation(s)
- Mingkun Zhan
- Department of Plastic Surgery, Fujian Medical University Union Hospital, Fujian Medical University, Fuzhou, China
| | - Robert L Anders
- School of Nursing, University of Texas at El Paso, El Paso, TX, USA.
| | - Bihua Lin
- Department of Plastic Surgery, Fujian Medical University Union Hospital, Fujian Medical University, Fuzhou, China
| | - Min Zhang
- Department of Pharmacy, Boston Medical Center, Boston, MA, USA
| | - Xiaosong Chen
- Department of Plastic Surgery, Fujian Medical University Union Hospital, Fujian Medical University, Fuzhou, China
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46
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Lopes N, Vernuccio F, Costantino C, Imburgia C, Gregoretti C, Salomone S, Drago F, Lo Bianco G. An Italian Guidance Model for the Management of Suspected or Confirmed COVID-19 Patients in the Primary Care Setting. Front Public Health 2020; 8:572042. [PMID: 33330317 PMCID: PMC7732472 DOI: 10.3389/fpubh.2020.572042] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 10/13/2020] [Indexed: 02/06/2023] Open
Abstract
An outbreak of Severe Acute Respiratory Syndrome Coronavirus 2 started in China's Hubei province at the end of 2019 has rapidly become a pandemic. In Italy, a great number of patients was managed in primary care setting and the role of general practitioners and physicians working in the first-aid emergency medical service has become of utmost importance to coordinate the network between the territory and hospitals during the pandemic. Aim of this manuscript is to provide a guidance model for the management of suspected, probable, or confirmed cases of SARS-CoV-2 infection in the primary care setting, from diagnosis to treatment, applying also the recommendations of the Italian Society of General Medicine. Moreover, this multidisciplinary contribution would analyze and synthetize the preventive measures to limit the spread of SARS-CoV-2 infection in the general population as well as the perspective for vaccines.
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Affiliation(s)
- Noemi Lopes
- Provincial Health Authority of Palermo, Palermo, Italy
| | - Federica Vernuccio
- Centro Neurolesi Bonino Pulejo Istituto di Ricovero e Cura a Carattere Scientifico - Scientific Institutes of Hospitalization and Care (IRCCS), Messina, Italy
- Department of Science for Health Promotion and Mother to Child Care, University of Palermo, Palermo, Italy
- Section of Radiology - Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Claudio Costantino
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Excellence Specialties “G. D'Alessandro”, University of Palermo, Palermo, Italy
| | - Claudia Imburgia
- Infectious Disease Unit, National Relevance Hospital Trust, Azienda Ospedaliera di Rilievo Nazionale e di Alta Specializzazione Civico Di Cristina e Benfratelli, Palermo, Italy
| | - Cesare Gregoretti
- Department of Surgical, Oncological, and Stomatological Sciences, University of Palermo, Palermo, Italy
- Anesthesiology and Pain Department, Fondazione Istituto G. Giglio, Cefalù, Italy
| | - Salvatore Salomone
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Filippo Drago
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Giuliano Lo Bianco
- Anesthesiology and Pain Department, Fondazione Istituto G. Giglio, Cefalù, Italy
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
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47
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Gallagher JE, K.C. S, Johnson IG, Al-Yaseen W, Jones R, McGregor S, Robertson M, Harris R, Innes N, Wade WG. A systematic review of contamination (aerosol, splatter and droplet generation) associated with oral surgery and its relevance to COVID-19. BDJ Open 2020; 6:25. [PMID: 33251028 PMCID: PMC7684564 DOI: 10.1038/s41405-020-00053-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 10/03/2020] [Accepted: 10/06/2020] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION The current COVID-19 pandemic caused by the SARS-CoV-2 virus has impacted the delivery of dental care globally and has led to re-evaluation of infection control standards. However, lack of clarity around what is known and unknown regarding droplet and aerosol generation in dentistry (including oral surgery and extractions), and their relative risk to patients and the dental team, necessitates a review of evidence relating to specific dental procedures. This review is part of a wider body of research exploring the evidence on bioaerosols in dentistry and involves detailed consideration of the risk of contamination in relation to oral surgery. METHODS A comprehensive search of Medline (OVID), Embase (OVID), Cochrane Central Register of Controlled Trials, Scopus, Web of Science, LILACS and ClinicalTrials.Gov was conducted using key terms and MeSH (Medical Subject Headings) words relating to the review questions. Methodological quality including sensitivity was assessed using a schema developed to measure quality aspects of studies using a traffic light system to allow inter- and intra-study overview and comparison. A narrative synthesis was conducted for assessment of the included studies and for the synthesis of results. RESULTS Eleven studies on oral surgery (including extractions) were included in the review. They explored microbiological (bacterial and fungal) and blood (visible and/or imperceptible) contamination at the person level (patients, operators and assistants) and/or at a wider environmental level, using settle plates, chemiluminescence reagents or air samplers; all within 1 m of the surgical site. Studies were of generally low to medium quality and highlighted an overall risk of contaminated aerosol, droplet and splatter generation during oral surgery procedures, most notably during removal of impacted teeth using rotatory handpieces. Risk of contamination and spread was increased by factors, including proximity to the operatory site, longer duration of treatment, higher procedural complexity, non-use of an extraoral evacuator and areas involving more frequent contact during treatment. CONCLUSION A risk of contamination (microbiological, visible and imperceptible blood) to patients, dental team members and the clinical environment is present during oral surgery procedures, including routine extractions. However, the extent of contamination has not been explored fully in relation to time and distance. Variability across studies with regards to the analysis methods used and outcome measures makes it difficult to draw robust conclusions. Further studies with improved methodologies, including higher test sensitivity and consideration of viruses, are required to validate these findings.
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Affiliation(s)
- Jennifer E. Gallagher
- Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, Denmark Hill Campus, Bessemer Road, London, SE5 9RS UK
| | - Sukriti K.C.
- Faculty of Dentistry, Oral & Craniofacial Surgery, King’s College London, Centre for Host Microbiome Interactions, Denmark Hill Campus, Bessemer Road, London, SE5 9RS UK
| | - Ilona G. Johnson
- Cardiff University School of Dentistry, Dental Public Health, Applied Clinical Research and Public Health, Heath Park, Cardiff, CF14 4XY UK
| | - Waraf Al-Yaseen
- School of Dentistry, Child Dental and Oral Health, University of Dundee, 2 Park Place, Dundee, DD1 4HR UK
| | - Rhiannon Jones
- College of Biomedical and Life Sciences, School of Dentistry, Cardiff University, Heath Park, Cardiff, CF14 4XY UK
| | - Scott McGregor
- Library and Learning Centre, University of Dundee, Dundee, DD1 4HR UK
| | - Mark Robertson
- School of Dentistry, Child Dental and Oral Health, University of Dundee, 2 Park Place, Dundee, DD1 4HR UK
| | - Rebecca Harris
- Department of Public Health, Policy & Systems, University of Liverpool, Room 124, 1st Floor, Block B, Waterhouse Building, 1-5 Brownlow Street, Liverpool, L69 3GL UK
| | - Nicola Innes
- College of Biomedical and Life Sciences, School of Dentistry, Cardiff University, Heath Park, Cardiff, CF14 4XY UK
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48
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Soriano JB, Anzueto A, Bosnic Anticevich S, Kaplan A, Miravitlles M, Usmani O, Papadopoulos NG, Puggioni F, Canonica GW, Roche N. Face masks, respiratory patients and COVID-19. Eur Respir J 2020; 56:13993003.03325-2020. [PMID: 32994197 PMCID: PMC7525001 DOI: 10.1183/13993003.03325-2020] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 09/07/2020] [Indexed: 11/05/2022]
Affiliation(s)
- Joan B Soriano
- Servicio de Neumología, Hospital Universitario La Princesa, Madrid, Spain .,Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Antonio Anzueto
- Division of Pulmonary Diseases and Critical Care Medicine, The University of Texas Health, San Antonio, TX, USA.,Pulmonary Diseases Section, Audie L. Murphy Memorial VA Hospital, South Texas Veterans Health Care System, San Antonio, TX, USA
| | - Sinthia Bosnic Anticevich
- Woolcock Institute of Medical Research, The University of Sydney, Sydney Local Health District, Sydney, Australia
| | - Alan Kaplan
- Dept of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Marc Miravitlles
- Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Pneumology Dept, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Omar Usmani
- National Heart and Lung Institute, Imperial College London and Royal Brompton Hospital, Airways Disease Section, London, UK
| | - Nikolaos G Papadopoulos
- Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, UK.,Allergy Dept, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
| | - Francesca Puggioni
- Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center, IRCCS, Rozzano, Italy.,Dept of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - G Walter Canonica
- Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center, IRCCS, Rozzano, Italy.,Dept of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Nicolas Roche
- Respiratory Medicine, Hôpital Cochin, APHP Centre, Université de Paris (UMR1016, Institut Cochin), Paris, France
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49
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Tabah A, Ramanan M, Laupland KB, Buetti N, Cortegiani A, Mellinghoff J, Conway Morris A, Camporota L, Zappella N, Elhadi M, Povoa P, Amrein K, Vidal G, Derde L, Bassetti M, Francois G, Ssi Yan Kai N, De Waele JJ. Personal protective equipment and intensive care unit healthcare worker safety in the COVID-19 era (PPE-SAFE): An international survey. J Crit Care 2020; 59:70-75. [PMID: 32570052 PMCID: PMC7293450 DOI: 10.1016/j.jcrc.2020.06.005] [Citation(s) in RCA: 188] [Impact Index Per Article: 47.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 06/08/2020] [Accepted: 06/10/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE To survey healthcare workers (HCW) on availability and use of personal protective equipment (PPE) caring for COVID-19 patients in the intensive care unit (ICU). MATERIALS AND METHOD A web-based survey distributed worldwide in April 2020. RESULTS We received 2711 responses from 1797 (67%) physicians, 744 (27%) nurses, and 170 (6%) Allied HCW. For routine care, most (1557, 58%) reportedly used FFP2/N95 masks, waterproof long sleeve gowns (1623; 67%), and face shields/visors (1574; 62%). Powered Air-Purifying Respirators were used routinely and for intubation only by 184 (7%) and 254 (13%) respondents, respectively. Surgical masks were used for routine care by 289 (15%) and 47 (2%) for intubations. At least one piece of standard PPE was unavailable for 1402 (52%), and 817 (30%) reported reusing single-use PPE. PPE was worn for a median of 4 h (IQR 2, 5). Adverse effects of PPE were associated with longer shift durations and included heat (1266, 51%), thirst (1174, 47%), pressure areas (1088, 44%), headaches (696, 28%), Inability to use the bathroom (661, 27%) and extreme exhaustion (492, 20%). CONCLUSIONS HCWs reported widespread shortages, frequent reuse of, and adverse effects related to PPE. Urgent action by healthcare administrators, policymakers, governments and industry is warranted.
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Affiliation(s)
- Alexis Tabah
- Intensive Care Unit, Faculty of Medicine, Redcliffe Hospital, University of Queensland, 4019, Redcliffe, Brisbane, Queensland 4029, Australia.
| | - Mahesh Ramanan
- Intensive Care Units, Caboolture and Prince Charles Hospitals, School of Medicine, University of Queensland, The George Institute for Global Health, University of New South Wales, Sydney, Queensland, Australia
| | - Kevin B Laupland
- Department of Intensive Care Services, Royal Brisbane and Women's Hospital, Queensland University of Technology, Brisbane, Queensland, Australia
| | | | - Andrea Cortegiani
- Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.) Section of Anesthesia, Analgesia, Intensive Care and Emergency Policlinico Paolo Giaccone University of Palermo Palermo, Italy
| | - Johannes Mellinghoff
- Faculty of Health and Social Care Education, Kingston & St George's University of London, UK
| | - Andrew Conway Morris
- Division of Anaesthesia, Department of Medicine, University of Cambridge, Cambridge, UK
| | - Luigi Camporota
- Centre for Human & Applied Physiological Sciences (CHAPS) and School of Basic & Medical Biosciences, Faculty of Life Sciences & Medicine, King's College London, Department of Critical Care, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Nathalie Zappella
- Anesthesiology and Critical Care Medicine Department, DMU PARABOL, Bichat - Claude Bernard Hospital, HUPNVS, AP-HP, Paris, France
| | | | - Pedro Povoa
- Sao Francisco Xavier Hospital, CHLO, NOVA Medical School, CHRC, New University of Lisbon, Lisbon, Portugal
| | - Karin Amrein
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria
| | - Gabriela Vidal
- Servicio de Terapia Intensiva, Hospital Interzonal de Agudos San Martin de La Plata, La Plata, Buenos Aires, Argentina
| | - Lennie Derde
- Intensive Care Center, University Medical Center Utrecht, Utrecht, the Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Matteo Bassetti
- Infectious Diseases Clinic, Department of Health Sciences, University of Genoa, Genoa and Hospital Policlinico San Martino-IRCCS, Genoa, Italy
| | - Guy Francois
- Division of Scientific Affairs, Research, European Society of Intensive Care Medicine, Brussels, Belgium
| | | | - Jan J De Waele
- Department of Critical Care Medicine, Ghent University Hospital, Gent, Belgium
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50
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Rutkowski JL, Camm DP, El Chaar E. AAID White Paper: Management of the Dental Implant Patient During the COVID-19 Pandemic and Beyond. J ORAL IMPLANTOL 2020; 46:454-466. [PMID: 32882035 DOI: 10.1563/aaid-joi-d-20-00316] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The scientific community's understanding of how the SARS-CoV-2 virus is transmitted and how to best mitigate its spread is improving daily. To help protect patients from acquiring COVID-19 from a dental office nosocomial infection, many state or local governments have classified dental treatments as "nonessential" and have paused routine dental care. Dentists have been instructed to perform only procedures designated as emergencies. Unfortunately, there is not a good understanding of what a dental emergency is among governmental leaders. What a government agency may perceive as an elective procedure may be seen as "essential" by the dental clinician responsible for maintaining the oral health of the patient. Each dental specialty understands the effects delayed care has on a patient's oral and systemic health. Dentistry has made extensive progress in improving oral health through prevention of the dental emergency. The dental profession must work together to prevent the reversal of the progress dentistry and patients have made. This American Academy of Implant Dentistry (AAID) White Paper discusses what COVID-19 is and how it impacts dental treatments, presents guidelines for dentistry in general and for dental implant related treatments, specifically. Recommendations for implant dentistry include the following: (1) what constitutes a dental implant related emergency, (2) how patients should be screened and triaged, (3) what personal protective equipment is necessary, (4) how operatories should be equipped, (5) what equipment should be used, and (6) what, when, and how procedures can be performed. This paper is intended to provide guidance for the dental implant practice so patients and dental health care providers can be safe, and offices can remain open and viable during the pandemic.
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Affiliation(s)
- James L Rutkowski
- Editor-in-Chief, Journal of Oral Implantology; University of Buffalo School of Dental Medicine, Buffalo, NY
| | | | - Edgard El Chaar
- College of Dentistry, New York University, New York, NY; private practice, New York, NY
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