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Haward R, G R, Kalyan M. The Impact of Personal Protective Equipment on Healthcare Workers on COVID-19 Duty in a Tertiary Care Hospital in South India. Cureus 2023; 15:e41910. [PMID: 37583728 PMCID: PMC10425167 DOI: 10.7759/cureus.41910] [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: 07/14/2023] [Indexed: 08/17/2023] Open
Abstract
Context The proper usage of personal protective equipment (PPE) must be prioritised for health care workers (HCWs), where shortages and prolonged use of personal protective equipment can threaten safety in essential health services. Aims To evaluate the effect of personal protective equipment on the health and well-being of HCWs, physicians, nurses, and technicians on duty for COVID-19 rotational postings. Settings and design This cross-sectional study was done by simple random sampling. Methods and materials This study was conducted at a tertiary care centre in South India to assess the utilisation of personal protective equipment (PPE) during the second wave of COVID-19. A physical questionnaire was distributed to a total of 266 healthcare workers, aged 20 to 50, who had worked for a minimum of three consecutive days between May and August 2021. The objective of the study was to evaluate the effectiveness of PPE use among healthcare workers during the second wave of the COVID-19 pandemic. Statistical analysis The data analysis in this study was conducted using IBM Statistical Package for Social Sciences (SPSS) version 19 (IBM Corp., Armonk, New York). The mean and standard deviation, or median, were used to present continuous variables, while frequency and percentage were used to present categorical variables. Furthermore, the minimum sample size required for this study was calculated to be 246 participants. Results The survey included 266 healthcare workers. The mean+/-SD of age was 28.18+/-5.64 and consisted of females (54.51%) and males (45.48%). The postings were in emergency (13.15%), intensive care unit (30.82%), and ward (56.01%), respectively. The HCWs who used PPE for four to seven days reported more symptoms than those who used it for one to three days. Discomforts experienced while wearing PPE were chest suffocation (49.62%), difficulty in performing intubation (36.09%), difficulty in seeing clearly (68.79%), dizziness (49.62%), excessive sweating (75.56%), micturition desire (52.63%), nausea (42.48%), retro-auricular pain (56.76%), stomach burns (27.44%), and thirst or dry throat (78.57%). The symptoms suffered after doffing were tiredness (69.17%), dry mouth (67.29%), dizziness (43.60%), headache (55.63%), chest suffocation (36.46%), dry skin (57.14%), reduced ability to concentrate (48.12%), dark-coloured urine (55.63%), reduced alertness (42.48%), and stomach burns (28.94%). The first thoughts after doffing were to drink water (68.42%), eat something (36.09%), clean yourself (61.27%), urinate (33.08%), and have some rest (29.32%), respectively. 81 (30.45%). The HCWs suffered skin injuries while wearing gloves. The time for restoring after a shift was 12 hours (37.59%), 24 hours (34.21%), 36 hours (11.65%), and 48 hours (16.59%). Pressure sores were reported on the forehead by 53 (19.92%) participants, the nose by 54 (20.30%), the cheek by 31 (11.65%), and behind the ear by 77 (65.71%) participants. The optimal size of PPE was experienced only by 76 (28.57%) participants, while 73 (27.44%) of them felt tight and 117 (43.98%) felt loose. Conclusions To minimise discomfort while managing infectious diseases, HCWs can adopt several practices like taking regular breaks, ensuring humane working hours, utilising high-quality PPE, and wearing properly fitting gear. By implementing these measures, HCWs can enhance their ability to handle infectious diseases effectively while prioritising their comfort and well-being.
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Affiliation(s)
- Raymond Haward
- Medical School, Vydehi Institute of Medical Science and Research Centre, Bangalore, IND
| | - Ridhima G
- Medical School, Vydehi Institute of Medical Science and Research Centre, Bangalore, IND
| | - Meenakshi Kalyan
- Internal Medicine, Vydehi Institute of Medical Science and Research Centre, Bangalore, IND
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Rossin ARS, Spessato L, Cardoso FDSL, Caetano J, Caetano W, Radovanovic E, Dragunski DC. Electrospinning in personal protective equipment for healthcare work. Polym Bull (Berl) 2023:1-24. [PMID: 37362955 PMCID: PMC10183089 DOI: 10.1007/s00289-023-04814-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 04/30/2023] [Accepted: 05/09/2023] [Indexed: 06/28/2023]
Abstract
Protection in many service areas is mandatory for good performance in daily activities of workers, especially health areas. Personal protective equipment (PPE) is used to protect patients and health workers from contamination by harmful pathogens and body fluids during clinical attendance. The pandemic scenario caused by SARS-CoV-2 has shown that the world is not prepared to face global disease outbreaks, especially when it comes to the PPE of healthcare workers. In the last years, the world has faced a deficiency in the development of advanced technologies to produce high-quality PPE to attend to the exponential increasing demand. Electrospinning is a technology that can be used to produce high-quality PPE by improving the protective action of clothing. In the face of this concern, this manuscript presents as focus the potential of electrospinning to be applied in protective clothing. PPE mostly used by healthcare workers are also presented. The physico-chemical characteristics and production processes of medical textiles for PPE are addressed. Furthermore, an overview of the electrospinning technique is shown. It is important to highlight most research about electrospinning applied to PPE for health areas presents gaps and challenges; thus, future projections are also addressed in this manuscript.
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Affiliation(s)
- Ariane Regina Souza Rossin
- Department of Chemistry, State University of Maringá, Maringá, Paraná 87020-900 Brazil
- Center of Engineering and Exact Sciences, State University of West Paraná, Toledo, Paraná 85903-000 Brazil
| | - Lucas Spessato
- Department of Chemistry, State University of Maringá, Maringá, Paraná 87020-900 Brazil
| | - Fabiana da Silva Lima Cardoso
- Department of Chemistry, State University of Maringá, Maringá, Paraná 87020-900 Brazil
- Center of Engineering and Exact Sciences, State University of West Paraná, Toledo, Paraná 85903-000 Brazil
| | - Josiane Caetano
- Center of Engineering and Exact Sciences, State University of West Paraná, Toledo, Paraná 85903-000 Brazil
| | - Wilker Caetano
- Department of Chemistry, State University of Maringá, Maringá, Paraná 87020-900 Brazil
| | - Eduardo Radovanovic
- Department of Chemistry, State University of Maringá, Maringá, Paraná 87020-900 Brazil
| | - Douglas Cardoso Dragunski
- Department of Chemistry, State University of Maringá, Maringá, Paraná 87020-900 Brazil
- Center of Engineering and Exact Sciences, State University of West Paraná, Toledo, Paraná 85903-000 Brazil
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Parsons Leigh J, Kemp LG, de Grood C, Brundin-Mather R, Stelfox HT, Ng-Kamstra JS, Fiest KM. A qualitative study of physician perceptions and experiences of caring for critically ill patients in the context of resource strain during the first wave of the COVID-19 pandemic. BMC Health Serv Res 2021; 21:374. [PMID: 33888096 PMCID: PMC8061878 DOI: 10.1186/s12913-021-06393-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 04/14/2021] [Indexed: 12/23/2022] Open
Abstract
Background The COVID-19 pandemic has led to global shortages in the resources required to care for critically ill patients and to protect frontline healthcare providers. This study investigated physicians’ perceptions and experiences of caring for critically ill patients in the context of actual or anticipated resource strain during the COVID-19 pandemic, and explored implications for the healthcare workforce and the delivery of patient care. Methods We recruited a diverse sample of critical care physicians from 13 Canadian Universities with adult critical care training programs. We conducted semi-structured telephone interviews between March 25–June 25, 2020 and used qualitative thematic analysis to derive primary themes and subthemes. Results Fifteen participants (eight female, seven male; median age = 40) from 14 different intensive care units described three overarching themes related to physicians’ perceptions and experiences of caring for critically ill patients during the pandemic: 1) Conditions contributing to resource strain (e.g., continuously evolving pandemic conditions); 2) Implications of resource strain on critical care physicians personally (e.g., safety concerns) and professionally (e.g. practice change); and 3) Enablers of resource sufficiency (e.g., adequate human resources). Conclusions The COVID-19 pandemic has required health systems and healthcare providers to continuously adapt to rapidly evolving circumstances. Participants’ uncertainty about whether their unit’s planning and resources would be sufficient to ensure the delivery of high quality patient care throughout the pandemic, coupled with fear and anxiety over personal and familial transmission, indicate the need for a unified systemic pandemic response plan for future infectious disease outbreaks. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06393-5.
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Affiliation(s)
- Jeanna Parsons Leigh
- Faculty of Health, School of Health Administration, Dalhousie University, Halifax, Nova Scotia, Canada. .,Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada. .,Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada. .,O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada.
| | - Laryssa G Kemp
- Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Chloe de Grood
- Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada
| | | | - Henry T Stelfox
- Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.,O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| | - Josh S Ng-Kamstra
- Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Kirsten M Fiest
- Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.,O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
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Alsaidan MS, Abuyassin AH, Alsaeed ZH, Alshmmari SH, Bindaaj TF, Alhababi AA. The Prevalence and Determinants of Hand and Face Dermatitis during COVID-19 Pandemic: A Population-Based Survey. Dermatol Res Pract 2020; 2020:6627472. [PMID: 33376481 PMCID: PMC7726962 DOI: 10.1155/2020/6627472] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 11/18/2020] [Accepted: 11/24/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND During the current COVID-19 pandemic, prevention is the key to limiting the spread of this disease. The frequent handwashing and use of sanitizers resulted in notable skin changes among some individuals. The aim of the study was to determine the prevalence and determinants of the new onset of dermatitis during the COVID-19 pandemic in a university population from Saudi Arabia. METHODS A cross-sectional study was conducted using a self-administered online questionnaire by sending an invitation link to students and employees of Prince Sattam Bin Abdulaziz University in June 2020. A chi-squared test was used to note differences regarding hand and face dermatitis. RESULTS Of the total 2356 participants, 34.8% reported skin changes or symptoms over hands, and 15.3% reported skin changes on their face during this pandemic. 88.7% of the participants reported a change in handwashing habits during the COVID-19 pandemic, and 62.2% of participants were not using any hand sanitizers before COVID-19 but began using them during the pandemic. There were significantly higher percentage of skin conditions in females (on hands (ScH): 42.6% and face (ScF):19.2%), individuals working in environments requiring frequent handwashing (ScH: 40.3% vs. ScF: 17.2%), those working in facilities where they have to interact with people during the pandemic (ScH: 41.1% vs. ScF: 18.7%), those encountering COVID-19 patients (ScH: 48.6% vs. ScF: 24.8%), those exposed to chemicals (ScH: 48.6% vs. ScF: 24.8%), and healthcare workers (ScH: 51.3% vs. ScF: 24.3%). CONCLUSION It was found that during the pandemic, skin changes were common among the general population as well as among healthcare workers. The frequency of handwashing and the use of alcohol-based sanitizers were contributing factors for dermatitis. Although hygiene is an extremely important preventive measure in this pandemic, maintaining skin integrity is also vital. Appropriate knowledge and good practice can prevent dermatitis in this pandemic, with regular hydration of the skin being a key factor.
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Affiliation(s)
- Mohammed Saud Alsaidan
- Internal Medicine Department, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
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A Qualitative Study of Barriers to Personal Protective Equipment Use among Laundry Workers in Government Hospitals, Hawassa, Ethiopia. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2020; 2020:5146786. [PMID: 33029156 PMCID: PMC7528124 DOI: 10.1155/2020/5146786] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/29/2020] [Accepted: 09/11/2020] [Indexed: 11/23/2022]
Abstract
Background The need to reduce the transmission of infectious diseases makes the use of personal protective equipment and safety medical devices compulsory among hospital laundry staff. The practice, however, remains to be low among hospital laundry staff members. Globally, not many studies seem to have been carried out to sufficiently tell us about the barriers to personal protective equipment use among hospital laundry workers. Related studies in Ethiopia are even fewer. This study assessed the barriers to personal protective equipment use among laundry staff of government hospitals in Hawassa City, Southern Ethiopia, 2019. Methods Two qualitative data-gathering methods—focus group discussions and key informant interviews—were used to collect data for this study. Eight focus group discussions were conducted with hospital laundry workers. Similarly, six key informant interviews were held with Infection Prevention and Patient Safety Officers. Thematic analysis was performed using Open Code 4.02. Result Organizational- and individual-level barriers such as unavailability of essential personal protective equipment, a disharmonious work environment, low perception of susceptibility, and belief about personal protective equipment interference with work performance were identified as the major barriers to personal protective equipment use in the present study. Conclusion Organizational- and individual-level barriers have been identified as causes for the low level of personal protective equipment use among hospital laundry workers. Therefore, improving institutional supplies in quantity and quality may have a positive implication for the improvement of infection prevention practices in the study area. Also, designing sustainable strategies and raising laundry workers' awareness of a safe work environment may lead to the improvement of infection prevention practices.
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Barratt R, Shaban RZ, Gilbert GL. Characteristics of personal protective equipment training programs in Australia and New Zealand hospitals: A survey. Infect Dis Health 2020; 25:253-261. [PMID: 32600965 PMCID: PMC7318937 DOI: 10.1016/j.idh.2020.05.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/15/2020] [Accepted: 05/17/2020] [Indexed: 12/19/2022]
Abstract
Background Using personal protective equipment (PPE) is one of several fundamental measures to prevent the transmission of infection and infectious diseases and is particularly pertinent in the current COVID-19 pandemic. Appropriate use of PPE by healthcare workers is, however, often suboptimal. Training and monitoring of PPE competency are essential components of an infection prevention and control program but there is a paucity of research and data on the content of such training programs across Australasia. This paper reports the results of a survey that characterised the nature of PPE training in Australian and New Zealand hospitals. Methods A population-based online survey was distributed to members of three major Australasian colleges representing infection prevention and control. Results Results indicate that, although training is frequently provided at orientation, many healthcare workers do not receive regular updates. Training programmes combine online and classroom sessions, but over a third do not include a practical component. The frequency of monitoring PPE competency is variable with one third of respondents indicating that no auditing occurs. PPE items used for high-level training are variable, with use of powered air purifying respirators (PAPRs) uncommon. Conclusion The results of this study suggest that HCWs’ confidence, competence and familiarity with PPE are a concern, which in the context of the current global COVID-19 pandemic is problematic. More research is needed into how PPE training programs could be better designed, to prepare HCWs for practice using PPE safely and confidently. Most HCW orientation programmes include PPE training but fewer than half are updated annually. One third of PPE programmes do not include a practical component. Only two thirds of PPE training programmes monitor PPE compliance. Future research should consider the design of PPE training programs to optimise HCW PPE practice.
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Affiliation(s)
- Ruth Barratt
- Centre for Infectious Diseases and Microbiology, Westmead Institute for Medical Research, 176 Hawkesbury Rd, Westmead, NSW 2145, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Camperdown, NSW, Australia; The University of Sydney Westmead Clinical School, Faculty of Medicine and Health, NSW, Australia.
| | - Ramon Z Shaban
- Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Camperdown, NSW, Australia; Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney. Camperdown. NSW, Australia; Directorate of Nursing, Midwifery and Clinical Governance, Western Sydney Local Health District, Westmead. NSW, Australia.
| | - Gwendolyn L Gilbert
- Centre for Infectious Diseases and Microbiology, Westmead Institute for Medical Research, 176 Hawkesbury Rd, Westmead, NSW 2145, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Camperdown, NSW, Australia; The University of Sydney Westmead Clinical School, Faculty of Medicine and Health, NSW, Australia.
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Katoh I, Tanabe F, Kasai H, Moriishi K, Shimasaki N, Shinohara K, Uchida Y, Koshiba T, Arakawa S, Morimoto M. Potential Risk of Virus Carryover by Fabrics of Personal Protective Gowns. Front Public Health 2019; 7:121. [PMID: 31179258 PMCID: PMC6538680 DOI: 10.3389/fpubh.2019.00121] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 04/30/2019] [Indexed: 11/13/2022] Open
Abstract
Personal protective gowns and coveralls are classified based on barrier efficiency that validates protection from fluid penetration under certain pressures. Materials standardized in this system have been found suitable for emergency medical practices confronting highly contagious diseases. Nevertheless, adhesion of blood, and body fluids from virus-infected patients to the surface of protective clothing still imposes a risk of pathogen transmission in the process of doffing, or undressing. We performed a small-scale experiment to test the possibility of infectious virus carryover on the surface of different fabrics used in commercially available protective gowns. Application of a lentivirus vector that expresses green fluorescent protein allowed easy monitoring of infectious viral loads on fabrics. Results indicate that fabrics of level-3 surgical gowns serve better to reduce virus transmission compared to fabrics of chemical protective clothing with the same or higher barrier efficiency. Analysis of sliding angles provided indexes of fluid repellency, which were inversely related to virus carryover potentials. Droplets of infectious body fluids may easily roll off fabrics with water-repellent finishing. Thus, virus carryover is a measurable risk factor to be considered for better choice of personal protective clothing.
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Affiliation(s)
- Iyoko Katoh
- Oral Health Science Research Center, Kanagawa Dental University, Yokosuka, Japan
| | | | - Hirotake Kasai
- Faculty of Medicine, University of Yamanashi, Chuo, Japan
| | - Kohji Moriishi
- Faculty of Medicine, University of Yamanashi, Chuo, Japan
| | - Noriko Shimasaki
- Influenza Virus Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Katsuaki Shinohara
- Division of Biosafety Control and Research, National Institute of Infectious Diseases, Tokyo, Japan
| | - Yukiko Uchida
- Faculty of Health and Welfare, Takasaki University of Health and Welfare, Takasaki, Japan
| | - Tomoko Koshiba
- Faculty of Fashion Science, Bunka Gakuen University, Tokyo, Japan
| | | | - Michiko Morimoto
- Faculty of Health and Welfare Science, Okayama Prefectural University, Soja, Japan
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Priorities, Barriers, and Facilitators towards International Guidelines for the Delivery of Supportive Clinical Care during an Ebola Outbreak: A Cross-Sectional Survey. Viruses 2019; 11:v11020194. [PMID: 30813456 PMCID: PMC6409845 DOI: 10.3390/v11020194] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 02/18/2019] [Accepted: 02/20/2019] [Indexed: 12/21/2022] Open
Abstract
During the Ebola outbreak, mortality reduction was attributed to multiple improvements in supportive care delivered in Ebola treatment units (ETUs). We aimed to identify high-priority supportive care measures, as well as perceived barriers and facilitators to their implementation, for patients with Ebola Virus Disease (EVD). We conducted a cross-sectional survey of key stakeholders involved in the response to the 2014⁻2016 West African EVD outbreak. Out of 57 email invitations, 44 responses were received, and 29 respondents completed the survey. The respondents listed insufficient numbers of health workers (23/29, 79%), improper tools for the documentation of clinical data (n = 22/28, 79%), insufficient material resources (n = 22/29, 76%), and unadapted personal protective equipment (n = 20/28, 71%) as the main barriers to the provision of supportive care in ETUs. Facilitators to the provision of supportive care included team camaraderie (n in agreement = 25/28, 89%), ability to speak the local language (22/28, 79%), and having treatment protocols in place (22/28, 79%). This survey highlights a consensus across various stakeholders involved in the response to the 2014⁻2016 EVD outbreak on a limited number of high-priority supportive care interventions for clinical practice guidelines. Identified barriers and facilitators further inform the application of guidelines.
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