scholarly journals Personal protective equipment in the COVID-19 pandemic and the use of cooling-wear as alleviator of thermal stress

2020 ◽  
Author(s):  
Hanna Luze ◽  
Sebastian P. Nischwitz ◽  
Petra Kotzbeck ◽  
Julia Fink ◽  
Judith C. J. Holzer ◽  
...  
Keyword(s):  
Thermal Stress ◽  
Patient Care ◽  
Personal Protective Equipment ◽  
Human Performance ◽  
Medical Personnel ◽  
Pilot Project ◽  
Negative Control ◽  
Physiological Parameters ◽  
Protective Equipment ◽  
Staff Members

Summary Background High temperatures at workplaces lead to health-related risks and premature exhaustion. The coronavirus disease 2019 (COVID-19) pandemic requires many health professionals to perform under unfavorable conditions. Personal protective equipment (PPE) causes thermal stress and negatively affects performance. Patients, materials and methods This pilot project investigated the effects of PPE and additional cooling wear on physiological parameters and concentration of six healthy staff members of the Plastic Surgery Department of the Medical University of Graz, Austria during simulated patient care. In this study two 1‑hour cycles with patient care-related tasks with PPE and PPE + cooling-wear, respectively, were conducted. A third cycle with scrubs exclusively served as baseline/negative control. The assessment occurred immediately pre-cycles and post-cycles. Results Pre-cycle assessments showed no significant differences between the cycles. After PPE cycle, increased physical stress levels and decrements in concentration capacity were observed. Physiological parameters were significantly less affected in the cooling cycle, while concentration capacity slightly increased. Conclusion COVID-19 PPE causes considerable thermal stress, ultimately affecting human performance. As opportunity to withstand thermal stress, and improve patients’ and professionals’ safety, cooling-wear can be considered relevant. Medical personnel performing in exceptional situations may particularly benefit from further development and investigation of cooling strategies.

scholarly journals Effects of personal protective equipment on the physiological parameters of health care workers

2020 ◽  
Vol 18 (7) ◽  
pp. 37-39
Author(s):  
Varun Mahajan, MD ◽  
Karan Singla, MD ◽  
Kamal Kajal, MD ◽  
Shiv Soni, MD ◽  
Amarjyoti Hazarika, MD ◽  
...  
Keyword(s):  
Health Care ◽  
Emergency Management ◽  
Patient Care ◽  
Health Care Workers ◽  
Personal Protective Equipment ◽  
Physiological Parameters ◽  
Protective Equipment ◽  
Physiological Effects ◽  
Care Workers

We would like to add to the study, Understanding the physiological effects of wearing enhanced personal protective equipment while providing patient care by Bulson and Shawl from the November/December 2019 issue of Journal of Emergency Management.

scholarly journals From natural disaster to pandemic: A health-system pharmacy rises to the challenge

2020 ◽  
Vol 77 (23) ◽  
pp. 1986-1993 ◽  
Author(s):  
Autumn D Zuckerman ◽  
Pratish C Patel ◽  
Mark Sullivan ◽  
Amy Potts ◽  
Molly Knostman ◽  
...  
Keyword(s):  
Health System ◽  
Patient Care ◽  
Natural Disaster ◽  
Personal Protective Equipment ◽  
Care Delivery ◽  
Protective Equipment ◽  
Staff Members ◽  
Quality Patient Care ◽  
Pharmacy Department ◽  
Virus Exposure

Abstract Purpose This report describes a health-system pharmacy’s response to a natural disaster while staff members simultaneously prepared for the coronavirus disease 2019 (COVID-19) pandemic. By detailing our experience, we hope to help other institutions that are current facing or could encounter similar crises. Summary In early March 2020, a tornado destroyed the health system’s warehouse for storage of most clinical supplies, including personal protective equipment and fluids. The pharmacy purchasing team collaborated with suppliers and manufacturers to recover losses and establish alternative storage areas. Days later, the pharmacy department was forced to address the impending COVID-19 pandemic. Key elements of the COVID-19 response included reducing the potential for virus exposure for patients and staff; overcoming challenges in sourcing of staff, personal protective equipment, and medications; and changing care delivery practices to maintain high-quality patient care while maximizing social distancing. The pharmacy department also created distance learning opportunities for 70 pharmacy students on rotations. After an initial plan, ongoing needs include adjustment in patient care activities if significant staff losses occur, when and how to resume clinical activities, and how to best utilize the resources accumulated. Elements of practice changes implemented to reduce COVID-19 threats to patients and pharmacy personnel have proven beneficial and will be further evaluated for potential continuation. Conclusion The pharmacy department’s efforts to respond to a natural disaster and unprecedented pandemic have proven successful to this point and have illuminated several lessons, including the necessity of cohesive department communication, staff flexibility, prioritization of teamwork, and external collaboration.

scholarly journals Specifying and Mitigating Thermal Stress Effects on Cognition During Personal Protective Equipment Use

2020 ◽  
Vol 62 (5) ◽  
pp. 697-703
Author(s):  
P. A. Hancock
Keyword(s):  
Intensive Care ◽  
Thermal Stress ◽  
Personal Protective Equipment ◽  
Health Workers ◽  
Cognitive Task ◽  
Medical Personnel ◽  
Protective Equipment ◽  
Specific Domain ◽  
Stress Effects ◽  
Care Facilities

Objective To report present understanding concerning selected task and environmental factors influencing the changing performance capacity associated with use of personal protective equipment (PPE). Background Much knowledge is available concerning change in complex cognitive capacities under the effects of thermal stress. Our science can inform critical care facilities as to remediation strategies such as work–rest schedules to minimize performance error in highly cognitively demanding circumstances such as intensive care units. Method The present exposition draws from the state-of-the-art understanding concerning thermal stress effects on cognition and workload in complex and demanding tasks. Results The summation and synthesis of HF/E findings provides important insights into combinatorial effects of forms of stress, typically dealt with only as discrete sources in traditional standards and regulations. The identified interaction between ascending thermal stress and cognitive task demand provides an instance of the plurality of ways HF/E can specify performance limitations in safety-critical circumstances, as witnessed in the current pandemic. Conclusion Accumulated HF/E insights provide systematic ways in which to address and ameliorate the combined forces of physical and cognitive stress on medical personnel constrained to use varying forms of PPE. These principles extend beyond this specific domain to all who are required to work in differential and isolated microclimates. Application To minimize the possibility of critical and life-threatening error in intensive care facilities which necessitate PPE use, we need principled work–rest ratio and heat stress mitigation guidance. To promote health, we need to champion healthy work practices in our health workers. HF/E insights can help achieve this important goal.

Infectious safety of nursing staff in departments (offices) functional diagnostics in the context of the COVID-19 pandemic

2020 ◽  
pp. 30-33
Author(s):  
E. V. Panina ◽  
M. V. Pugachev ◽  
A. G. Shchesiu
Keyword(s):  
Medical Care ◽  
Nursing Staff ◽  
Personal Protective Equipment ◽  
Medical Personnel ◽  
Medical Waste ◽  
Daily Activities ◽  
Protective Equipment ◽  
Functional Diagnostics ◽  
Prevention Of Infections ◽  
Epidemiological Situation

The article shows that in the daily activities of nursing staff of functional diagnostics departments (offices), it is necessary to strictly observe the requirements and rules for the prevention of infections associated with medical care, especially during the COVID-19 pandemic. The types of personal protective equipment (PPE) of medical personnel (MP), as well as current effective methods of disinfection, rules for collecting medical waste in a complex epidemiological situation are presented.

scholarly journals Rapid implementation of Inpatient eConsult Programme addresses new challenges for patient care during COVID-19 pandemic

2021 ◽  
pp. bmjinnov-2020-000557
Author(s):  
Sharon Rikin ◽  
Eric J Epstein ◽  
Inessa Gendlina
Keyword(s):  
Palliative Care ◽  
Infectious Diseases ◽  
Patient Care ◽  
Personal Protective Equipment ◽  
Protective Equipment ◽  
Qualitative Feedback ◽  
The Usa ◽  
New Challenges ◽  
Science Framework ◽  
Context Specific

IntroductionAt the early epicentre of the COVID-19 crisis in the USA, our institution saw a surge in the demand for inpatient consultations for areas impacted by COVID-19 (eg, infectious diseases, nephrology, palliative care) and shortages in personal protective equipment (PPE). We aimed to provide timely specialist input for consult requests during the COVID-19 pandemic by implementing an Inpatient eConsult Programme.MethodsWe used the reach, effectiveness, adoption, implementation and maintenance implementation science framework and run chart analysis to evaluate the reach, adoption and maintenance of the Inpatient eConsult Programme compared with traditional in-person consults. We solicited qualitative feedback from frontline physicians and specialists for programme improvements.ResultsDuring the study period, there were 46 available in-person consult orders and 21 new eConsult orders. At the peak of utilisation, 42% of all consult requests were eConsults, and by the end of the study period, utilisation fell to 20%. Qualitative feedback revealed subspecialties best suited for eConsults (infectious diseases, nephrology, haematology, endocrinology) and influenced improvements to the ordering workflow, documentation, billing and education regarding use.DiscussionWhen offered inpatient eConsult requests as an alternative to in-person consults in the context of a surge in patients with COVID-19, frontline physicians used eConsult requests and decreased use of in-person consults. As the demand for consults decreased and PPE shortages were no longer a major concern, eConsult utilisation decreased, revealing a preference for in-person consultations when possible.ConclusionsLessons learnt can be used to develop and implement inpatient eConsults to meet context-specific challenges at other institutions.

scholarly journals Implementing a Massive Personal Protective Equipment Education—A Multidisciplinary Team Approach

2020 ◽  
Vol 41 (S1) ◽  
pp. s280-s281
Author(s):  
Mayar Al Mohajer ◽  
Megan Fischer ◽  
Melissa Rouse ◽  
Takei Pipkins ◽  
John Byrne
Keyword(s):  
Nursing Education ◽  
Personal Protective Equipment ◽  
Multidisciplinary Team ◽  
Infection Prevention ◽  
Just In Time ◽  
Protective Equipment ◽  
Team Approach ◽  
Online Video ◽  
Staff Members ◽  
Multidisciplinary Team Approach

Background: Personal protective equipment (PPE) is defined by the Occupational Safety and Health Administration as specialized clothing or equipment worn by an employee for protection against infectious materials. They include gloves, gowns, masks, respirators, googles and face shields. The CDC has issued guidelines on appropriateness of when, what, and how to use PPE. Despite these guidelines, compliance with PPE remains challenging. Methods: We implemented a massive hospital-wide rapid education program on PPE donning and doffing of all employees and staff. This program included an online video, return demonstration and just-in-time training. To develop the program, we recorded PPE training video, reviewed PPE validation checklist, developed new isolation precaution signage with quick response (QR) code to video, developed a nutrition tray removal video and a equipment cleaning video, developed family and visitor guidelines for isolation precautions, and created an audit tool for PPE donning and doffing practices. The program required interdisciplinary collaboration including administration, infection prevention, nursing education, central supply, environmental services, facility maintenance, and security. Results: The first phase of the program was implemented through 30 separate 4-hour PPE skills fair offered over 48 hours. In total, 500 staff members were trained in the first 48 hours; 6 additional 3-hour sessions were provided on site in the following 3 month. Additionally, training was provided in off-site clinics, physician leadership meetings, new-hire orientation for nursing staff, and monthly resident and fellow training through graduate medical education. As needed, training was provided by infection prevention, nursing education, and floor nurses. In total, 5,237 staff members were trained within 3 months after implementation. Actual audit results (50 audits per week) showed improved and sustained compliance to >94%. Conclusions: A massive hospital-wide educational program including online video, return demonstration, and just-in-time training is a feasible and very effective method to improve compliance with PPE donning and doffing. A multidisciplinary team approach, administration support, and continuous education and audits are key factors in successful implementation.Funding: NoneDisclosures: None

scholarly journals Protected Code Stroke

Stroke ◽  
2020 ◽  
Vol 51 (6) ◽  
pp. 1891-1895 ◽  
Author(s):  
Houman Khosravani ◽  
Phavalan Rajendram ◽  
Lowyl Notario ◽  
Martin G. Chapman ◽  
Bijoy K. Menon
Keyword(s):  
Resource Management ◽  
Personal Protective Equipment ◽  
Human Performance ◽  
Clinical Status ◽  
Stroke Care ◽  
Infection Prevention And Control ◽  
Protective Equipment ◽  
Healthcare Team ◽  
Crisis Resource Management ◽  
Screening Criteria

Background and Purpose— Hyperacute assessment and management of patients with stroke, termed code stroke, is a time-sensitive and high-stakes clinical scenario. In the context of the current coronavirus disease 2019 (COVID-19) pandemic caused by the SARS-CoV-2 virus, the ability to deliver timely and efficacious care must be balanced with the risk of infectious exposure to the clinical team. Furthermore, rapid and effective stroke care remains paramount to achieve maximal functional recovery for those needing admission and to triage care appropriately for those who may be presenting with neurological symptoms but have an alternative diagnosis. Methods— Available resources, COVID-19-specific infection prevention and control recommendations, and expert consensus were used to identify clinical screening criteria for patients and provide the required nuanced considerations for the healthcare team, thereby modifying the conventional code stroke processes to achieve a protected designation. Results— A protected code stroke algorithm was developed. Features specific to prenotification and clinical status of the patient were used to define precode screening. These include primary infectious symptoms, clinical, and examination features. A focused framework was then developed with regard to a protected code stroke. We outline the specifics of personal protective equipment use and considerations thereof including aspects of crisis resource management impacting team role designation and human performance factors during a protected code stroke. Conclusions— We introduce the concept of a protected code stroke during a pandemic, as in the case of COVID-19, and provide a framework for key considerations including screening, personal protective equipment, and crisis resource management. These considerations and suggested algorithms can be utilized and adapted for local practice.

scholarly journals Patient-Worn Enhanced Protection Face Shield for Flexible Endoscopy

2020 ◽  
Vol 163 (2) ◽  
pp. 280-283 ◽  
Author(s):  
Jack B. Anon ◽  
Carter Denne ◽  
Darcy Rees
Keyword(s):  
Personal Protective Equipment ◽  
Health Care Professionals ◽  
Medical Personnel ◽  
Flexible Endoscopy ◽  
Primary Objective ◽  
Protective Equipment ◽  
Fiberoptic Endoscopy ◽  
Institutional Review ◽  
Inferior Aspect ◽  
Fluorescein Dye

Objectives The primary objective of this study was to compare the protection afforded by a standard face shield design with a new enhanced design in a controlled setting. Methods This study was exempted from review by institutional review board waiver. A flexible fiberoptic endoscopy was placed through stellate openings in the standard face shield and the enhanced face shield. A series of simulated coughs were created with bursts of fluorescein dye through an atomizer tip placed within the test participant’s mouth. Ultraviolet lighting illuminated the test area, and areas of dye splatter were noted. Results Fluorescein dye is easily aerosolized along the lateral inferior aspect of a standard shield with significant contamination of the surrounds. The enhanced face shield maintained a barrier to the aerosolized dye. Discussion Face shields, rather than face masks, should be considered a preferred alternative for the public and for health care professionals alike, as they address many of the personal protective equipment concerns especially during the COVID-19 pandemic. Otolaryngologists are at high risk from aerosol-generating procedures, such as flexible fiberoptic endoscopy, even when wearing personal protective equipment. Here we describe a uniquely designed face shield to be worn by the patient as another layer of protection for the environment and for medical personnel. Implications for Practice During the course of a flexible fiberoptic endoscopy, medical personnel are safely isolated from potential infectious particles with a newly designed face shield.

scholarly journals Practices of Midwives in the Use of Personal Protective Equipment when Aid Labor during the COVID-19 Pandemic

2021 ◽  
Vol 1 (2) ◽  
pp. 173-179
Author(s):  
Shinta Novelia ◽  
Rosmawati Lubis ◽  
Reni Murniati ◽  
Bunga Tiara Carolin
Keyword(s):  
Personal Protective Equipment ◽  
Sampling Technique ◽  
Medical Personnel ◽  
Average Score ◽  
Protective Equipment ◽  
Validity And Reliability ◽  
Chi Square ◽  
Cross Sectional ◽  
Personal Protection Equipment ◽  
Average Value

Background: In the era of the COVID-19 pandemic, the use of personal protective equipment (PPE) is very important to reduce the risk of transmitting infectious diseases to medical personnel because it can prevent contact with pathogens. This shows that midwives as first-line managers of pregnancy, childbirth and postpartum cases must be vigilant by wearing complete Personal Protection Equipment (PPE) so that there is no transmission of the virus from the patient to the midwife. Objective: To determine the analysis of midwives' practices in using PPE when assisting labor during the COVID-19 pandemic at the Banten Regional General Hospital 2020-2021. Methodology: A quantitative analytic study using a cross sectional approach. The sample in this study was 102 respondents with purposive sampling technique. Data were analyzed using SPSS with Chi Square, which previously tested the validity and reliability. Results: The use of PPE in midwives in Banten Hospital obtained an average value of 84.3. Based on age, the average value was 53.9. Based on the length of service, the average score was 96.1. Based on education, the average score is 55.9. The results of the chi-square test showed that all independent variables had no relationship with the use of PPE including knowledge (p = 0.323), attitude (p = 0.665), availability of PPE (p = 0.740), and supervision (p = 0.603). Conclusions and Suggestions: The use of PPE in midwives has no relationship with knowledge, attitudes, availability of PPE and supervision. There is a need for socialization about the importance of using PPE to midwives in order to maintain the quality of expected care services. There is a need for an K3 unit in Banten Hospital which is one of the authorities. There needs to be special attention from the Hospital Management regarding the supervision of the use of PPE in midwives.

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