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Nigri RB, Silva RFAD. Hemodialysis in the context of COVID-19: care, nursing protagonism and quality. Rev Bras Enferm 2021; 75:e20201077. [PMID: 34614071 DOI: 10.1590/0034-7167-2020-1077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 04/18/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To reflect on the need to reorganize satellite dialysis units to ensure the safety of patients and workers, focusing on minimizing the risk of contamination by SARS-CoV-2. METHODS Reflection considering the guidelines of international and Brazilian institutions and scientific articles, with a view to possible adaptations to the Brazilian reality. RESULTS The actions suggested and adapted by Dialysis Units from different countries during the pandemic focus on the quality of care and safety of the patient and workers. There was an opportunity to reflect on these actions using the Donabedian Model for quality of care and highlight the nursing team's role in this context. FINAL CONSIDERATIONS The focus on quality and safety related to institutionalized processes and the assessment through indicators can contribute to the management of the outpatient dialysis unit in the context of COVID 19.
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Chen CY, Ye JJ, Huang TS, Lee CC, Chen YT, Hsu CK, Hsu HJ, Sun CY, Pan HC, Chen KS, Kao HH, Ko CC, She YH, Wu CY, Lai CC, Hwang SJ, Wu IW. Effective Preventive Strategies to Prevent Secondary Transmission of COVID-19 in Hemodialysis Unit: The First Month of Community Outbreak in Taiwan. Healthcare (Basel) 2021; 9:healthcare9091173. [PMID: 34574947 PMCID: PMC8467394 DOI: 10.3390/healthcare9091173] [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: 08/17/2021] [Revised: 08/31/2021] [Accepted: 09/03/2021] [Indexed: 11/25/2022] Open
Abstract
Background: Dialyzed patients are vulnerable to coronavirus infection disease 2019 (COVID-19). The incidence and outcome of COVID-19 in hemodialysis (HD) patients in Taiwan remain unclear. A series of preventive measures were executed to combat COVID-19 transmission among HD patients. Methods: We carried out a series of forward-looking and practical preventive strategies of COVID-19 control in our HD center. Incidences of COVID-19 of our HD unit were compared with those of national and local estimates from a community outbreak from 15 May to 30 June 2021. Prognostic factors associated with mortality were analyzed. Results: The national incidence of COVID-19 was 0.062%; being highest in Taipei City (0.173%), followed by New Taipei City (0.161%) and Keelung (0.083%). The overall incidence in Keelung HD patients was 0.666%. One patient of our HD center contracted COVID-19 from the household; however, we have contained secondary transmission in our HD center by implementing strict preventive measures. The mortality rate of HD patients in Keelung was 66.6%. The median Ct value of HD patients was 17.53 (11.75–27.90) upon diagnosis. The deceased patients had a higher cardiac/thoracic ratio than alive (0.61 vs. 0.55, p = 0.036). Conclusions: Taking aggressive and proactive infection preventive measures impedes the secondary transmission of COVID-19 in HD facilities. COVID-19-associated mortality was high in HD patients, being the high cardiac-thoracic ratio, an important prognostic factor for clinical outcome of infected HD patients.
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Affiliation(s)
- Chun-Yu Chen
- Department of Nephrology, Chang Gung Memorial Hospital, Keelung 204, Taiwan; (C.-Y.C.); (C.-C.L.); (Y.-T.C.); (C.-K.H.); (H.-J.H.); (C.-Y.S.); (H.-C.P.); (K.-S.C.); (H.-H.K.); (C.-C.K.); (Y.-H.S.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
| | - Jung-Jr Ye
- Department of Infectious Diseases, Chang Gung Memorial Hospital, Keelung 204, Taiwan;
| | - Ting-Shuo Huang
- Community Medicine Research Center, Department of General Surgery, Chang Gung Memorial Hospital, Keelung 204, Taiwan;
- Department of Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Chin-Chan Lee
- Department of Nephrology, Chang Gung Memorial Hospital, Keelung 204, Taiwan; (C.-Y.C.); (C.-C.L.); (Y.-T.C.); (C.-K.H.); (H.-J.H.); (C.-Y.S.); (H.-C.P.); (K.-S.C.); (H.-H.K.); (C.-C.K.); (Y.-H.S.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
| | - Yih-Ting Chen
- Department of Nephrology, Chang Gung Memorial Hospital, Keelung 204, Taiwan; (C.-Y.C.); (C.-C.L.); (Y.-T.C.); (C.-K.H.); (H.-J.H.); (C.-Y.S.); (H.-C.P.); (K.-S.C.); (H.-H.K.); (C.-C.K.); (Y.-H.S.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
| | - Cheng-Kai Hsu
- Department of Nephrology, Chang Gung Memorial Hospital, Keelung 204, Taiwan; (C.-Y.C.); (C.-C.L.); (Y.-T.C.); (C.-K.H.); (H.-J.H.); (C.-Y.S.); (H.-C.P.); (K.-S.C.); (H.-H.K.); (C.-C.K.); (Y.-H.S.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
| | - Heng-Jung Hsu
- Department of Nephrology, Chang Gung Memorial Hospital, Keelung 204, Taiwan; (C.-Y.C.); (C.-C.L.); (Y.-T.C.); (C.-K.H.); (H.-J.H.); (C.-Y.S.); (H.-C.P.); (K.-S.C.); (H.-H.K.); (C.-C.K.); (Y.-H.S.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
| | - Chiao-Yin Sun
- Department of Nephrology, Chang Gung Memorial Hospital, Keelung 204, Taiwan; (C.-Y.C.); (C.-C.L.); (Y.-T.C.); (C.-K.H.); (H.-J.H.); (C.-Y.S.); (H.-C.P.); (K.-S.C.); (H.-H.K.); (C.-C.K.); (Y.-H.S.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
| | - Heng-Chih Pan
- Department of Nephrology, Chang Gung Memorial Hospital, Keelung 204, Taiwan; (C.-Y.C.); (C.-C.L.); (Y.-T.C.); (C.-K.H.); (H.-J.H.); (C.-Y.S.); (H.-C.P.); (K.-S.C.); (H.-H.K.); (C.-C.K.); (Y.-H.S.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
| | - Kuo-Su Chen
- Department of Nephrology, Chang Gung Memorial Hospital, Keelung 204, Taiwan; (C.-Y.C.); (C.-C.L.); (Y.-T.C.); (C.-K.H.); (H.-J.H.); (C.-Y.S.); (H.-C.P.); (K.-S.C.); (H.-H.K.); (C.-C.K.); (Y.-H.S.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
| | - Hao-Hsi Kao
- Department of Nephrology, Chang Gung Memorial Hospital, Keelung 204, Taiwan; (C.-Y.C.); (C.-C.L.); (Y.-T.C.); (C.-K.H.); (H.-J.H.); (C.-Y.S.); (H.-C.P.); (K.-S.C.); (H.-H.K.); (C.-C.K.); (Y.-H.S.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
| | - Chia-Chun Ko
- Department of Nephrology, Chang Gung Memorial Hospital, Keelung 204, Taiwan; (C.-Y.C.); (C.-C.L.); (Y.-T.C.); (C.-K.H.); (H.-J.H.); (C.-Y.S.); (H.-C.P.); (K.-S.C.); (H.-H.K.); (C.-C.K.); (Y.-H.S.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
| | - Yun-Hsuan She
- Department of Nephrology, Chang Gung Memorial Hospital, Keelung 204, Taiwan; (C.-Y.C.); (C.-C.L.); (Y.-T.C.); (C.-K.H.); (H.-J.H.); (C.-Y.S.); (H.-C.P.); (K.-S.C.); (H.-H.K.); (C.-C.K.); (Y.-H.S.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
| | - Chun-Ying Wu
- Department of Laboratory Medicine, Chang Gung Memorial Hospital, Keelung 204, Taiwan;
| | - Chi-Chun Lai
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung 204, Taiwan
| | - Shang-Jyh Hwang
- Department of Internal Medicine, Division of Nephrology, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan;
- Faculty of Renal Care, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - I-Wen Wu
- Department of Nephrology, Chang Gung Memorial Hospital, Keelung 204, Taiwan; (C.-Y.C.); (C.-C.L.); (Y.-T.C.); (C.-K.H.); (H.-J.H.); (C.-Y.S.); (H.-C.P.); (K.-S.C.); (H.-H.K.); (C.-C.K.); (Y.-H.S.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
- Correspondence: ; Tel.: +886-2-24313131-6211
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Schneider G, Bim FL, Sousa ÁFLD, Watanabe E, Andrade DD, Fronteira I. The use of antimicrobial-impregnated fabrics in health services: an integrative review. Rev Lat Am Enfermagem 2021; 29:e3416. [PMID: 33852687 PMCID: PMC8040786 DOI: 10.1590/1518-8345.4668.3416] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 09/19/2020] [Indexed: 11/22/2022] Open
Abstract
Objective: to analyze evidence concerning the feasibility of antimicrobial-impregnated fabrics in preventing and controlling microbial transmission in health services. Method: an integrative review using the following databases: MEDLINE (via PubMed), Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, and Latin American and Caribbean Health Sciences Literature (LILACS), regardless of language and date of publication. Seven studies were included in the analysis to verify the types of fabrics and substances used to impregnate the fabrics, applicability in health services, and decrease in microbial load. Results: silver nanoparticles and copper oxide are the main antimicrobial substances used to impregnate the fabrics. The patients’ use of these fabrics, such as in bed and bath linens and clothing, was more effective in reducing antimicrobial load than in health workers’ uniforms. Conclusion: the use of these antimicrobial-impregnated textiles, especially by patients, is a viable alternative to prevent and control microbial transmission in health services. Implementing these fabrics in health workers’ uniforms requires further studies, however, to verify its effectiveness in decreasing microbial load in clinical practice.
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Affiliation(s)
- Guilherme Schneider
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil.,Scholarship holder at the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil
| | - Felipe Lazarini Bim
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil.,Scholarship holder at the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil
| | - Álvaro Francisco Lopes de Sousa
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil.,Universidade Nova de Lisboa, Instituto de Higiene e Medicina Tropical, Lisboa, Portugal.,Scholarship holder at the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil
| | - Evandro Watanabe
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Ribeirão Preto, SP, Brazil
| | - Denise de Andrade
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil.,Scholarship holder at the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil
| | - Inês Fronteira
- Universidade Nova de Lisboa, Instituto de Higiene e Medicina Tropical, Lisboa, Portugal
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Lee J, Hwang S, Huang J. Review of the present features and the infection control challenges of COVID-19 pandemic in dialysis facilities. Kaohsiung J Med Sci 2020; 36:393-398. [PMID: 32492290 PMCID: PMC7300887 DOI: 10.1002/kjm2.12239] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 05/07/2020] [Accepted: 05/07/2020] [Indexed: 01/08/2023] Open
Abstract
The COVID-19 has swept the world causing suffering, death, loss, and massive economy damage. The dialysis population is vulnerable and the dialysis facility is critical in maintaining operations and avoiding disease transmission. The present information regarding the clinical features of COVID-19 infection in the dialysis population was collected, and the useful measures of COVID-19 infection prevention and infection control in the dialysis facilities were summarized. Leadership, education, preparedness, management, and recovery phase were determined to be the critical procedures. It is hoped this updated interim review might provide information for medical professionals to take proactive action to best prepare and mitigate damage when facing the COVID-19 pandemic challenge.
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Affiliation(s)
- Jia‐Jung Lee
- Division of Nephrology, Department of Internal MedicineKaohsiung Medical University HospitalKaohsiungTaiwan
- Faculty of Medicine, College of MedicineKaohsiung Medical UniversityKaohsiungTaiwan
- Faculty of Renal Care, College of MedicineKaohsiung Medical UniversityKaohsiungTaiwan
| | - Shang‐Jyh Hwang
- Division of Nephrology, Department of Internal MedicineKaohsiung Medical University HospitalKaohsiungTaiwan
- Faculty of Medicine, College of MedicineKaohsiung Medical UniversityKaohsiungTaiwan
- Faculty of Renal Care, College of MedicineKaohsiung Medical UniversityKaohsiungTaiwan
| | - Jee‐Fu Huang
- Faculty of Medicine, College of MedicineKaohsiung Medical UniversityKaohsiungTaiwan
- Division of Hepatobiliary, Department of Internal MedicineKaohsiung Medical University HospitalKaohsiungTaiwan
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