The Impact of Environmental Design on Doffing Personal Protective Equipment in a Healthcare Environment: A Formative Human Factors Trial

2017 ◽  
Vol 38 (06) ◽  
pp. 712-717 ◽  
Author(s):  
Tracey A. Herlihey ◽  
Stefano Gelmi ◽  
Joseph A. Cafazzo ◽  
Trevor N. T. Hall
Keyword(s):  
Human Factors ◽  
Personal Protective Equipment ◽  
Environmental Design ◽  
Healthcare Setting ◽  
Worker Safety ◽  
Protective Equipment ◽  
Safety Communication ◽  
Healthcare Environment ◽  
Design Changes ◽  
The Impact

OBJECTIVE To explore the impact of environmental design on doffing personal protective equipment in a simulated healthcare environment. METHODS A mixed-methods approach was used that included human-factors usability testing and qualitative questionnaire responses. A patient room and connecting anteroom were constructed for testing purposes. This experimental doffing area was designed to overcome the environmental failures identified in a previous study and was not constructed based on any generalizable hospital standard. RESULTS In total, 72 healthcare workers from Ontario, Canada, took part in the study and tested the simulated doffing area. The following environmental design changes were tested and were deemed effective: increasing prominence of color-coded zones; securing disinfectant wipes and hand sanitizer; outlining disposal bins locations; providing mirrors to detect possible contamination; providing hand rails to assist with doffing; and restricting the space to doff. Further experimentation and iterative design are required with regard to several important features: positioning the disposal bins for safety, decreasing the risk of contamination and user accessibility; optimal positioning of mirrors for safety; communication within the team; and positioning the secondary team member for optimal awareness. Additional design suggestions also emerged during this study, and they require future investigation. CONCLUSIONS This study highlights the importance of the environment on doffing personal protective equipment in a healthcare setting. Iterative testing and modification of the design of the environment (doffing area) are important to enhancing healthcare worker safety. Infect Control Hosp Epidemiol 2017;38:712–717

Impact of COVID-19 on Nuclear Medicine in Germany, Austria and Switzerland: An International Survey in April 2020

2020 ◽  
Vol 59 (04) ◽  
pp. 294-299 ◽  
Author(s):  
Lutz S. Freudenberg ◽  
Ulf Dittmer ◽  
Ken Herrmann
Keyword(s):  
Nuclear Medicine ◽  
Health Systems ◽  
Personal Protective Equipment ◽  
Large Scale ◽  
Diagnostic Procedures ◽  
Protective Equipment ◽  
Current Crisis ◽  
Web Based ◽  
Public Versus Private ◽  
The Impact

Abstract Introduction Preparations of health systems to accommodate large number of severely ill COVID-19 patients in March/April 2020 has a significant impact on nuclear medicine departments. Materials and Methods A web-based questionnaire was designed to differentiate the impact of the pandemic on inpatient and outpatient nuclear medicine operations and on public versus private health systems, respectively. Questions were addressing the following issues: impact on nuclear medicine diagnostics and therapy, use of recommendations, personal protective equipment, and organizational adaptations. The survey was available for 6 days and closed on April 20, 2020. Results 113 complete responses were recorded. Nearly all participants (97 %) report a decline of nuclear medicine diagnostic procedures. The mean reduction in the last three weeks for PET/CT, scintigraphies of bone, myocardium, lung thyroid, sentinel lymph-node are –14.4 %, –47.2 %, –47.5 %, –40.7 %, –58.4 %, and –25.2 % respectively. Furthermore, 76 % of the participants report a reduction in therapies especially for benign thyroid disease (-41.8 %) and radiosynoviorthesis (–53.8 %) while tumor therapies remained mainly stable. 48 % of the participants report a shortage of personal protective equipment. Conclusions Nuclear medicine services are notably reduced 3 weeks after the SARS-CoV-2 pandemic reached Germany, Austria and Switzerland on a large scale. We must be aware that the current crisis will also have a significant economic impact on the healthcare system. As the survey cannot adapt to daily dynamic changes in priorities, it serves as a first snapshot requiring follow-up studies and comparisons with other countries and regions.

scholarly journals The COVID-19 Pandemic and nursing challenges: A review of the early literature

Work ◽  
2021 ◽  
pp. 1-14
Author(s):  
Mojtaba K. Danesh ◽  
Ehsan Garosi ◽  
Hamedeh Golmohamadpour
Keyword(s):  
Health Systems ◽  
Personal Protective Equipment ◽  
Qualitative Studies ◽  
Systematic Search ◽  
Current Paper ◽  
Protective Equipment ◽  
Early Literature ◽  
The Face ◽  
Physical Distress ◽  
The Impact

BACKGROUND: The COVID-19 pandemic has put health systems under unprecedented pressure, challenging their workforce, especially nurses. OBJECTIVE: The current paper presented a review of the early literature concerning emerging nursing challenges during the early stages of the COVID-19 pandemic. METHODS: A systematic search of the published literature between January and May 2020 was carried out in Medline, Science Direct, and Google Scholar to identify relevant quantitative and qualitative studies. RESULTS: Twenty-two original articles were retrieved, the majority of which were survey studies from China. Synthesis of the evidence resulted in four overarching themes including “being physically and mentally drained in the face of fear and uncertainty,” “shortage of personal protective equipment and usability issues,” “psychosomatic disturbances among nurses,” and “moderators to mitigate nurses’ challenges.” CONCLUSIONS: Providing care for demanding COVID-19 patients, nurses experienced a gruelling situation, during which a significant amount of psychological and physical distress was inflicted to them. However, receiving proper support from their organization and society could improve the condition substantially. Further research is required to explore the impact of the COVID-19 pandemic on nurses, especially from Western countries.

scholarly journals Retrospective Study on Personal Protective Equipment During Pandemic Link to Outbreak of Carbpenem-Resistant Enterobacteriace

2021 ◽  
Vol 1 (S1) ◽  
pp. s9-s10
Author(s):  
Kenisha Evans ◽  
Jennifer LeRose ◽  
Angela Beatriz Cruz ◽  
Lavina Jabbo ◽  
Teena Chopra
Keyword(s):  
Retrospective Study ◽  
Infection Control ◽  
Personal Protective Equipment ◽  
Horizontal Transmission ◽  
Control Measures ◽  
Protective Equipment ◽  
Local Health ◽  
Infection Rates ◽  
Infection Control Measures ◽  
The Impact

Background: In 2019, according to the Centers for Disease Control and Prevention, carbapenem-resistant Enterobacteriaceae (CRE), had cost the lives of >35,000 patients, particularly the most virulent plasmid-mediated New Delhi metallo-β-lactamase (NDM). Although healthcare systems normally have strict surveillance and infection control measures for CRE, the rapid emergence of novel SAR-CoV-2 and COVID-19 led to a shortage of personal protective equipment (PPE) and medical supplies. As a result, routine infection practices, such as contact precautions, were violated. Studies have shown this depletion and shift in resources compromised the control of infections such CRE leading to rising horizontal transmission. Method: A retrospective study was conducted at a tertiary healthcare system in Detroit, Michigan, to determine the impact of PPE shortages during the COVID-19 pandemic on NDM infection rates. The following periods were established during 2020 based on PPE availability: (1) pre-PPE shortage (January–June), (2) PPE shortage (July–October), and (3) post-PPE shortage (November–December). Rates of NDM per 10,000 patient days were compared between periods using the Wilcoxon signed rank-sum test. Isolates were confirmed resistant by NDM by molecular typing performed by the Michigan State Health Department. Patient characteristics were gathered by medical chart review and patient interviews by telephone. Results: Overall, the average rate of NDM infections was 1.82 ±1.5 per 10,000 patient days. Rates during the PPE shortage were significantly higher, averaging 3.6 ±1.1 cases per 10,000 patient days (P = .02). During this time, several infections occurred within patients on the same unit and/or patients with same treating team, suggesting possible horizontal transmission. Once PPE stock was replenished and isolation practices were reinstated, NDM infection rates decreased to 0.77 ±1.1 per 10,000 patient days. Conclusion: Control of CRE requires strategic planning with active surveillance, antimicrobial constructs, and infection control measures. The study illustrates that in times of crisis, such as the COVID-19 pandemic, the burden of effective infection control requires much more multidisciplinary efforts to prevent unintentional lapses in patient safety. A swift response by the state and local health departments at a tertiary-care healthcare center conveyed a positive mitigation of the highest clinical threats and decreased horizontal transmission of disease.Funding: NoDisclosures: None

scholarly journals The Impact Of COVID-19 On Out-Of-Hours Adult Hospice Care: An Online Survey

2021 ◽  
Author(s):  
Felicity Hasson ◽  
Paul Slater ◽  
Anne Fee ◽  
Tracey McConnell ◽  
Sheila Payne ◽  
...  
Keyword(s):  
Palliative Care ◽  
United Kingdom ◽  
Personal Protective Equipment ◽  
Protective Equipment ◽  
Community Based ◽  
Out Of Hours ◽  
Care Services ◽  
The United Kingdom ◽  
Palliative Care Services ◽  
The Impact

Abstract BackgroundGlobally COVID-19 has had a profound impact on the provision of healthcare, including palliative care. However, there is little evidence about the impact of COVID-19 on delivery of out-of-hours specialist palliative care services in the United Kingdom. The aim of the study is to investigate the impact of the COVID-19 pandemic on the delivery of out-of-hours community-based palliative care services.Methods A national online census survey of managers of adult hospices in the United Kingdom was undertaken. Survey were emailed to managers of adult hospices (n=150) who provided out-of-hours community palliative care services. Fifteen questions related specifically to the impact of COVID-19 and data were analysed thematically.ResultsEighty-one responses to the survey were returned (54% response rate); 59 were complete of which 47 contained COVID-19 data. Findings indicated that COVID-19 impacted on out-of-hours community-based palliative care. To meet increased patient need, hospices reconfigured services; redeployed staff; and introduced new policies and procedures to minimize virus transmission. Lack of integration between charitably and state funded palliative care providers was reported. The interconnected issues of the use and availability of Personal Protective Equipment (n=21) and infection control screening (n=12) resulted in changes in nursing practices due to fear of contagion for patients, carers and staff. Conclusions Survey findings suggest that due to increased demand for community palliative care services, hospices had to rapidly adapt and reconfigure services. Even though this response to the pandemic led to some service improvements, in the main, out-of-hours service reconfiguration resulted in challenges for hospices, including workforce issues, and availability of resources such as Personal Protective Equipment. These challenges were exacerbated by lack of integration with wider healthcare services. More research is required to fully understand the implications of such changes on the quality of care provided.

scholarly journals The impact of COVID-19 pandemic on dental practice in Iran: a questionnaire-based report

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Hanie Ahmadi ◽  
Alireza Ebrahimi ◽  
Farhad Ghorbani
Keyword(s):  
Personal Protective Equipment ◽  
Dental Health ◽  
Protective Equipment ◽  
Dental Practice ◽  
Online Questionnaire ◽  
Dental Services ◽  
Emergency Procedures ◽  
Dental Procedures ◽  
Dental Practitioners ◽  
The Impact

Abstract Background The highly contagious nature of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV2), besides the fact that dental procedures commonly generate blood and saliva droplets that could lead to the contagion have resulted in the closure of many dental clinics. In the present study, we aimed to evaluate the impact of coronavirus disease 2019 (COVID-19) pandemic on dental practice by conducting an online questionnaire among the Iranian dental practitioners and finding their perspectives on the subject. Methods This report is based on a questionnaire that was conducted among Iranian dentists. The survey included questions that evaluate the dentists’ perceptions and attitudes toward the COVID-19 pandemic and its effect on their personal life, financial status, and the quality of dental services for patients. Results Overall, 240 dentists contributed to this study (214 general dentists and 26 specialists). The majority of the participants (n = 170, 70%) did not perform non-emergency procedures during the pandemic. The dental practitioners have suggested several strategies to decrease the risk of contagion, such as reducing treatment sessions (n = 90, 37%), strict triage of patients (n = 156, 64%), and using personal protective equipment (n = 108, 45%). However, most of the dentists (n = 210, 87%) had problems, providing personal protective equipment during the pandemic. Moreover, 97% (n = 234) of the participants reported that they encountered a decrease in their financial income since the eruption of the pandemic. Conclusion Dental health care workers are at the highest risk of contracting COVID-19. Thus, dental practitioners ought to execute the standard protocols more cautiously during the pandemic. They could also lower their work hours and limit dental procedures to emergency treatments to reduce the risk of COVID-19 transmission. Besides, the public organizations should provide proper equipment for the dental practitioners to decrease the risk of contagion.

scholarly journals Rapid Review of SARS-CoV-1 and SARS-CoV-2 Viability, Susceptibility to Treatment, and the Disinfection and Reuse of PPE, Particularly Filtering Facepiece Respirators

2020 ◽  
Vol 17 (17) ◽  
pp. 6117 ◽  
Author(s):  
José G. B. Derraik ◽  
William A. Anderson ◽  
Elizabeth A. Connelly ◽  
Yvonne C. Anderson
Keyword(s):  
Health Care ◽  
Ultraviolet Light ◽  
Nursing Staff ◽  
Personal Protective Equipment ◽  
Rapid Review ◽  
Protective Equipment ◽  
Health Care Settings ◽  
The Impact

In the COVID-19 pandemic caused by SARS-CoV-2, hospitals are often stretched beyond capacity. There are widespread reports of dwindling supplies of personal protective equipment (PPE), particularly N95-type filtering facepiece respirators (FFRs), which are paramount to protect frontline medical/nursing staff, and to minimize further spread of the virus. We carried out a rapid review to summarize the existing literature on the viability of SARS-CoV-2, the efficacy of key potential disinfection procedures against the virus (specifically ultraviolet light and heat), and the impact of these procedures on FFR performance, material integrity, and/or fit. In light of the recent discovery of SARS-CoV-2 and limited associated research, our review also focused on the closely related SARS-CoV-1. We propose a possible whole-of-PPE disinfection solution for potential reuse that could be rapidly instituted in many health care settings, without significant investments in equipment.

scholarly journals Self-Contamination While Doffing Personal Protective Equipment

2020 ◽  
Vol 41 (S1) ◽  
pp. s385-s386
Author(s):  
Jaqueline Pereira da Silva ◽  
Priyadarshini Pennathur ◽  
Hugh Salehi ◽  
Emily Chasco ◽  
Jure Baloh ◽  
...  
Keyword(s):  
Human Factors ◽  
Personal Protective Equipment ◽  
Demographic Data ◽  
Protective Equipment ◽  
Human Factors Engineering ◽  
Academic Hospital ◽  
Training Video ◽  
Exposed Skin ◽  
Before And After ◽  
Trained Staff

Background: Personal protective equipment (PPE) effectiveness can be undermined by inappropriate doffing methods. Objective: We used human factors engineering methods to evaluate self-contamination during PPE doffing. Methods: In this study, 30 participants at a Midwestern academic hospital (A) donned and doffed 3 mask styles (n = 10), 2 gown styles (n = 10), and 2 glove styles (n = 10; the Doffy glove has a tab to facilitate doffing). Also, 30 additional participants at hospital A (residents or fellows, nurses, special isolation trained staff [SITS]) and 10 SITS at academic hospital B doffed a surgical mask, a breakaway neck gown, and exam gloves (PPE ensemble) twice: once while distracted with conversation and once when not distracted. We randomized the order in which participants used different PPE styles or they did the doffing scenario. We collected demographic data. We applied Glo Germ Mist (1.5 dilution in water) with a mucosal atomizer to participants’ PPE before they doffed. We video-recorded participants as they doffed, and we photographed their scrubs and exposed skin before and after each donning and doffing episode. We reviewed videos for doffing errors and photographs for fluorescent spots. We counted fluorescent spots and noted their locations. Results: Overall, 45 (64.3%) participants were women, 31 (44.3%) were nurses, 24 (34.3%) were physicians. Among the participants, 25 (35.7%) had >15 years of experience and 61 (87.1%) had some training in doffing. Participants frequently contaminated their skin or clothing while doffing (Table 1). For all scenarios, hands followed by the torso were contaminated most frequently. Analysis of the videos found that touching the gown front with bare hands was the most common doffing error. Fewer participants self-contaminated when using the Doffy glove without training than when using the standard exam glove. Although most participants in the glove trial indicated that they did not need to watch the Doffy glove training video again, most had difficulty doffing the Doffy glove with the beak method. Many participants stopped doffing to answer questions when they doffed the PPE ensemble during the interruption scenario. Conclusions: Self-contamination was very common with all PPE styles and during all scenarios. Distraction did not increase the risk of contamination. However, participants often stopped doffing to answer questions, which they rarely do in practice. Watching a video was inadequate training for the beak glove-doffing method. The Doffy glove, which decreased contamination compared with the standard glove in the untrained scenario, may have advantages over standard exam gloves and should be evaluated further.Funding: NoneDisclosures: None

scholarly journals Impact of enhanced personal protective equipment on the physical and mental well-being of healthcare workers during COVID-19

2020 ◽  
pp. postgradmedj-2020-139150 ◽  
Author(s):  
Ramanathan Swaminathan ◽  
Bimantha Perera Mukundadura ◽  
Shashi Prasad
Keyword(s):  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Healthcare Professionals ◽  
Negative Impact ◽  
Well Being ◽  
Cross Sectional Study ◽  
Protective Equipment ◽  
Cross Sectional ◽  
The Impact ◽  
Mental Well Being

BackgroundThe COVID-19 pandemic has necessitated the use of enhanced personal protective equipment (PPE) in healthcare workers in patient-facing roles. We describe the impact on the physical and mental well-being of healthcare professionals who use enhanced PPE consistently.MethodsWe conducted a single-centre, cross-sectional study among healthcare professionals who use enhanced PPE. A web-based questionnaire was disseminated to evaluate the effects on individuals’ physical and mental well-being. Physical and mental impact was assessed through a visual analogue scale.ResultsProspective analysis of the views of 72 respondents is reported. 63.9% were women and 36.1% were men. Physical impact included exhaustion, headache, skin changes, breathlessness and a negative impact on vision. Communication difficulties, somnolence, negative impact on overall performance and difficulties in using surgical instrumentation were reported.ConclusionOur study demonstrates the undeniable negative impact on the front-line healthcare workers using enhanced PPE and lays the ground for larger multicentric assessments given for it to potentially be the norm for the foreseeable future.

Immune Buildings - Using Ergonomics and Environmental Design to Create Safe and Secure Settings

2002 ◽  
Vol 46 (9) ◽  
pp. 859-859
Author(s):  
Alan Hedge
Keyword(s):  
Human Factors ◽  
Terrorist Attack ◽  
Environmental Design ◽  
Airport Security ◽  
Indoor Environments ◽  
Sexual Assaults ◽  
The Third ◽  
Design Changes ◽  
Building Ventilation ◽  
Building Designs

The horrendous events in September of last year, from airplane attacks on large buildings to bioterrorism in postal and other government facilities, raised awareness of the vulnerability many modern buildings to terrorist attack and the importance of designing safer buildings that impede terrorist activity and that can facilitate occupant egress at a time of crisis. This symposium will examine the role that Human Factors professionals can play in improving the design of Immune Buildings, designed to better protect occupants and minimize the risks of hostile activity. Four papers will be presented that will examine human factors contributions to new ways of thinking about buildings. The first paper by James Wise will describe approaches to de-opportunizing such undesirable behaviors and environmental design changes that can thwart vandalism, burglaries, bank robberies, physical and sexual assaults, and counterterrorist situations. The second paper by Jake Pauls will review opportunities for changing building designs to impede terrorist ingress and facilitate occupant egress in times of need. The third paper by Alan Hedge will review ways that building ventilation systems can be configured to minimize bioterrorist threats on indoor environments by implementing a concept of ‘smart furniture’. The fourth paper by Eric Neiderman will examine the contributions that human factors can make to improving airport security.

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