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Singh R, Mittal G, Srivastava A. Needle Stick Injury Among Healthcare Workers in a Tertiary Care Setting in Dehradun, Sub-Himalayan Region: A Four-Year Record-Based Study. Cureus 2024; 16:e58448. [PMID: 38765417 PMCID: PMC11100269 DOI: 10.7759/cureus.58448] [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] [Accepted: 04/17/2024] [Indexed: 05/22/2024] Open
Abstract
INTRODUCTION Needlestick injuries (NSIs) represent a significant occupational health risk in healthcare settings. These injuries, caused by contaminated sharps such as needles, vials, and scalpel blades, can lead to percutaneous exposure to infectious materials. Despite the severity of NSIs, they often go unreported, highlighting a critical gap in occupational safety protocols. AIMS This study aimed to investigate the occurrence of NSIs among healthcare workers (HCWs) by sex, profession, and working areas. It also sought to explore the underlying reasons for these injuries and the factors contributing to their underreporting. METHODOLOGY Adhering to the RECORD guidelines (Reporting of studies Conducted using Observational Routinely Collected Data), this record-based study involved a retrospective analysis of reported NSIs. Data were collected from voluntary reports by HCWs who experienced NSIs or exposure to potentially infectious materials such as blood and body fluids. Statistical analysis was conducted using IBM SPSS Statistics for Windows, Version 16 (Released 2007; IBM Corp., Armonk, New York) and Microsoft Excel 2010 (Microsoft Corporation, Redmond, Washington). RESULTS Data from 142 participants indicated a higher proportion of females experiencing NSIs compared to males, with rates of 57.7% pre-COVID and 60.6% during COVID. There were notable shifts in NSI rates across professions, with increases observed among staff nurses and ward attendants/helpers. Analysis of injury circumstances revealed a decrease in sampling procedure-related injuries but an increase during intravenous procedures and biomedical waste segregation. Injuries occurring on the right-hand index finger decreased from 52.1% pre-COVID to 31% during COVID, while those on the left-hand index finger increased from 19.7% pre-COVID to 39.4% during COVID. Statistically significant associations were found between the injury site and the place of occurrence (p=0.021). Healthcare professionals commonly cleansed the site with disinfectants and used personal protective equipment (PPE) kits, with increased PPE usage noted during the COVID-19 pandemic. These findings emphasize the evolving dynamics of NSIs among HCWs and underscore the importance of tailored preventive measures during pandemics.
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Affiliation(s)
- Rajender Singh
- Department of Microbiology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, IND
| | - Garima Mittal
- Department of Microbiology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, IND
| | - Abhay Srivastava
- Department of Community Medicine, Himalayan Institute of Medical Sciences, Dehradun, IND
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Evrin T, Dabkowski M, Pruc M, Hernik J, Wieczorek W, Chabowski L, Wieczorek P, Chmielewski J, Feduniw S, Szarpak L. ETView SL versus Macintosh Direct Laryngoscope for Endotracheal Intubation Amid Simulated COVID-19 Cardiac Arrest: A Randomized Crossover Study. J Clin Med 2023; 12:5074. [PMID: 37568476 PMCID: PMC10419956 DOI: 10.3390/jcm12155074] [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: 07/04/2023] [Revised: 07/23/2023] [Accepted: 07/31/2023] [Indexed: 08/13/2023] Open
Abstract
Airway management procedures, such as endotracheal intubation (ETI), pose a significant risk of aerosol generation, requiring robust personal protective equipment (PPE) against aerosol-generating procedures (AGP). This study aimed to assess the impact of PPE-AGP on intubation success rates, time to intubation, and glottic visualization using ETView and a standard Macintosh laryngoscope (MAC). A total of 52 physicians participated in this prospective, observational, randomized crossover study conducted in a medical simulation setting. Participants included COVID-19 patients with cardiac arrest scenarios with and without PPE-AGP who were intubated with ETView and MAC. During intubation without PPE-AGP, ETView showed a similar first-pass success rate (FPS) but had a shorter intubation time and better glottal hydration compared to MAC. In scenario B (with PPE-AGP), ETView outperformed MAC in FPS, initiation time, and glottic visualization. The use of PPE-AGP had little impact on ETView's performance. However, it negatively affected the Macintosh laryngoscope, reducing FPS and glottic visibility. Participants found intubation with ETView easier in both scenarios. In conclusion, as compared to the Macintosh laryngoscope, ETView demonstrated higher performance under the circumstances of the simulation, especially when PPE-AGP was used.
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Affiliation(s)
- Togay Evrin
- Department of Emergency Medicine, Medical Faculty, Ufuk University, 06510 Ankara, Turkey
| | - Miroslaw Dabkowski
- Research Unit, Polish Society of Disaster Medicine, 05-806 Warsaw, Poland
| | - Michal Pruc
- Research Unit, Polish Society of Disaster Medicine, 05-806 Warsaw, Poland
- Department of Public Health, International Academy of Ecology and Medicine, 02000 Kyiv, Ukraine
| | - Jacek Hernik
- Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, 00-136 Warsaw, Poland
| | - Wojciech Wieczorek
- Research Unit, Polish Society of Disaster Medicine, 05-806 Warsaw, Poland
- Department of Emergency Medicine, Medical University of Warsaw, 02-013 Warsaw, Poland
| | - Lukasz Chabowski
- Research Unit, Polish Society of Disaster Medicine, 05-806 Warsaw, Poland
- Department of Public Health, Odessa International Medical University, 12042 Odessa, Ukraine
| | - Pawel Wieczorek
- Research Unit, Polish Society of Disaster Medicine, 05-806 Warsaw, Poland
- Pediatric Intensive Care Unit (PICU), John Paul II Upper Silesian Health Centre in Katowice, 40-752 Katowice, Poland
| | - Jaroslaw Chmielewski
- Institute of Environmental Protection—National Research Institute (IEP-NRI), 02-170 Warsaw, Poland
- Department of Public Health, International European University, 03187 Kyiv, Ukraine
| | - Stepan Feduniw
- Department of Obstetrics, University Hospital Zurich, 8091 Zurich, Switzerland
- Department of Gynecology, University Hospital Zurich, 8091 Zurich, Switzerland
| | - Lukasz Szarpak
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX 77030, USA
- Research Unit, Maria Sklodowska-Curie Bialystok Oncology Center, 15-027 Bialystok, Poland
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Joseph K, Chan PSF, Fang Y, Chen S, Mo PKH, Wang Z. Knowledge and practice of personal protective measures against COVID-19 in Africa: a systematic review. JMIR Public Health Surveill 2023; 9:e44051. [PMID: 37058578 DOI: 10.2196/44051] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 03/29/2023] [Accepted: 04/10/2023] [Indexed: 04/16/2023] Open
Abstract
BACKGROUND The Coronavirus disease 2019 (COVID-19) pandemic being a newly evolving disease, its response measures largely depend on the practice of and compliance with personal protective measures (PPMs). OBJECTIVE This systematic review aimed to examine the knowledge and practice of COVID-19 PPMs in African countries, as documented in the published literature. METHODS A systematic search was conducted on Scopus, PubMed, and Web of Science databases using appropriate keywords and predefined eligibility criteria for the selection of relevant studies. Only population-based original research studies (including qualitative, quantitative, and mixed-method studies) done in Africa, and published in the English language were included. The screening process and data extraction were performed according to a pre-registered protocol in PROSPERO (CRD42022355101) and followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The quality of included studies was assessed using the Mixed-Method Appraisal Tool. Thematic analysis was used to systematically summarise the studies into four predefined domains: i) knowledge and perception about PPMs, ii) mask use, iii) social/physical distancing, and iv) hand washing/hygiene, including their respective levels and associated factors. RESULTS A total of 58 studies across 12 African countries were included, and these were published between 2019 and 2022. African communities, including various population groups, had varying levels of knowledge and practice of COVID-19 PPMs, with lack of personal protective equipment (PPE) (mainly face masks), and side effects (among health care workers) being the major reasons for poor compliance. Lower rates of handwashing/ hygiene were particularly noted in several African countries, especially among the urban poor and slum-dwellers, with the main barrier being the lack of safe and clean water. Various cognitive (knowledge and perception), socio-demographic and economic factors were associated with the practice of COVID-19 PPMs. Moreover, there were evident research inequalities on the regional level, where East Africa contributed 36.2%, West Africa 20.7%, North Africa 17.2%, Southern Africa 6.9%, and no single-country study from Central Africa. Nonetheless, the overall quality of the included studies was generally good, as they satisfied most of the quality assessment criteria. CONCLUSIONS There is a need to enhance local capacity to produce and supply PPE. Consideration of various cognitive, demographic and socioeconomic differences, with extra focus on the most vulnerable, is crucial for inclusive and more effective strategies against the pandemic. Moreover, more focus and involvement in community behavioral research are needed to fully understand and address the dynamics of the current pandemic in Africa. CLINICALTRIAL The study protocol was registered in PROSPERO (CRD42022355101).
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Affiliation(s)
- Kawuki Joseph
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China, Room 508, School of Public Health, Prince of Wales Hospital,, Shatin, N.T., HK
| | - Paul Shing-Fong Chan
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China, Room 508, School of Public Health, Prince of Wales Hospital,, Shatin, N.T., HK
| | - Yuan Fang
- Department of Health and Physical Education, the Education University of Hong Kong, Hong Kong, China, New Territories, HK
| | - Siyu Chen
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China, Room 508, School of Public Health, Prince of Wales Hospital,, Shatin, N.T., HK
| | - Phoenix K H Mo
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China, Room 508, School of Public Health, Prince of Wales Hospital,, Shatin, N.T., HK
| | - Zixin Wang
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China, Room 508, School of Public Health, Prince of Wales Hospital,, Shatin, N.T., HK
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Oosthuizen I, Saunders GH, Manchaiah V, Swanepoel DW. Impact of SARS-CoV-2 Virus (COVID-19) Preventative Measures on Communication: A Scoping Review. Front Public Health 2022; 10:815259. [PMID: 35419343 PMCID: PMC8995421 DOI: 10.3389/fpubh.2022.815259] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 03/02/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Face coverings and distancing as preventative measures against the spread of the Coronavirus disease 2019 may impact communication in several ways that may disproportionately affect people with hearing loss. A scoping review was conducted to examine existing literature on the impact of preventative measures on communication and to characterize the clinical implications. Method A systematic search of three electronic databases (Scopus, PubMed, CINAHL) was conducted yielding 2,158 articles. After removing duplicates and screening to determine inclusion eligibility, key data were extracted from the 50 included articles. Findings are reported following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Extension for Scoping Reviews, including the PRISMA-ScR checklist. Results Studies fell into three categories: Studies addressing the impacts of personal protective equipment (PPE) and/or distancing on communication in healthcare contexts (n = 20); studies examining the impact of preventative measures on communication in everyday life (n = 13), and studies measuring the impact of face coverings on speech using acoustic and/or behavioral measures (n = 29). The review revealed that masks disrupt verbal and non-verbal communication, as well as emotional and social wellbeing and they impact people with hearing loss more than those without. These findings are presumably because opaque masks attenuate sound at frequencies above 1 kHz, and conceal the mouth and lips making lipreading impossible, and limit visibility of facial expressions. While surgical masks cause relatively little sound attenuation, transparent masks and face shields are highly attenuating. However, they are preferred by people with hearing loss because they give access to visual cues. Conclusion Face coverings and social distancing has detrimental effects that extend well beyond verbal and non-verbal communication, by affecting wellbeing and quality of life. As these measures will likely be part of everyday life for the foreseeable future, we propose that it is necessary to support effective communication, especially in healthcare settings and for people with hearing loss.
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Affiliation(s)
- Ilze Oosthuizen
- Department of Speech-language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Virtual Hearing Lab, Collaborative Initiative Between University of Colorado School of Medicine, Aurora, CO, United States, and University of Pretoria, Pretoria, South Africa
| | - Gabrielle H. Saunders
- Manchester Centre for Audiology and Deafness (ManCAD), University of Manchester, Manchester, United Kingdom
| | - Vinaya Manchaiah
- Department of Speech-language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Virtual Hearing Lab, Collaborative Initiative Between University of Colorado School of Medicine, Aurora, CO, United States, and University of Pretoria, Pretoria, South Africa
- Department of Otolaryngology–Head and Neck Surgery, University of Colorado School of Medicine, Aurora, CO, United States
- UCHealth Hearing and Balance, University of Colorado Hospital, Aurora, CO, United States
- Department of Speech and Hearing, School of Allied Health Sciences, Manipal Academy of Higher Education, Manipal, India
| | - De Wet Swanepoel
- Department of Speech-language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Virtual Hearing Lab, Collaborative Initiative Between University of Colorado School of Medicine, Aurora, CO, United States, and University of Pretoria, Pretoria, South Africa
- Ear Science Institute Australia, Subiaco, WA, Australia
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Alarfaj MA, Foula MS, Alshammary S, Nwesar FA, Eldamati AM, Alomar A, Abdulmomen AA, Alarfaj L, Almulhim A, Alarfaj O, Zakaria HM. Impact of wearing personal protective equipment on the performance and decision making of surgeons during the COVID-19 pandemic: An observational cross-sectional study. Medicine (Baltimore) 2021; 100:e27240. [PMID: 34664867 PMCID: PMC8448053 DOI: 10.1097/md.0000000000027240] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 08/28/2021] [Indexed: 01/10/2023] Open
Abstract
During the coronavirus disease 2019 (COVID-19) pandemic, the mandatory use of personal protective equipment (PPE) has resulted in a significant reduction in the infection rate among health care workers (HCWs). However, there are some ongoing concerns about the negative impact of using PPE for prolonged periods.This study examined the impact of wearing PPE on surgeons' performance and decision making during the COVID-19 pandemic.In this cross-sectional study, an anonymous online questionnaire was created and disseminated to surgeons all over the Eastern Province of Saudi Arabia. The questionnaire included the demographic data, the local hospital policies, the non-technical skills (e.g., communication, vision, and comfort) and the technical skills, and the process of decision making.From June 2020 to August 2020, 162 surgeons participated in this questionnaire. Of them, 80.2% were aged from 26 to 45 years, 70.4% have received a special training for PPE, and 59.3% of participants have operated on COVID-19 confirmed cases. A negative impact of wearing PPE was reported on their overall comfort, vision, and communication skills (92.6%, 95.1%, and 82.8%, respectively). The technical skills and decision making were not significantly affected (60.5% and 72.8%, respectively). More preference for conservative approach, damage control procedures, and/or open approach was reported.Despite its benefits, PPE is associated with a significant negative impact on the non-technical skills (including vision, communication, and comfort) as well as a non-significant negative impact on technical skills and decision making of surgeons. Extra efforts should be directed to improve PPE, especially during lengthy pandemics.
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Affiliation(s)
- Mosab A. Alarfaj
- Department of Surgery, King Fahad University Hospital, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
| | - Mohammed S. Foula
- Department of Surgery, King Fahad University Hospital, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
| | - Shadi Alshammary
- Department of Surgery, King Fahad University Hospital, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
| | - Fayrouz A. Nwesar
- Department of Obstetrics and Gynaecology, Alexandria Maternity University Hospital, Alexandria, Egypt
| | - Ahmed M. Eldamati
- Department of Surgery, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Abdullah Alomar
- Department of Surgery, King Fahad University Hospital, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
| | - Abdulrahim A. Abdulmomen
- Department of Surgery, King Fahad University Hospital, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
| | - Leenah Alarfaj
- Department of Surgery, King Fahad Specialist Hospital, Dammam Saudi Arabia
| | - Abdulmohsen Almulhim
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Odai Alarfaj
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Hazem M. Zakaria
- Department of Surgery, King Fahad University Hospital, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
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