Beyond personal protective equipment: adjunctive methods for control of healthcare-associated respiratory viral infections

2020 ◽  
Vol 33 (4) ◽  
pp. 312-318
Author(s):  
Zachary M. Most
Keyword(s):  
Personal Protective Equipment ◽  
Viral Infections ◽  
Protective Equipment ◽  
Respiratory Viral Infections ◽  
Healthcare Associated

scholarly journals Antiviral surfaces and coatings and their mechanisms of action

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Paulina D. Rakowska ◽  
Mariavitalia Tiddia ◽  
Nilofar Faruqui ◽  
Claire Bankier ◽  
Yiwen Pei ◽  
...  
Keyword(s):  
Antimicrobial Peptides ◽  
Personal Protective Equipment ◽  
Viral Infections ◽  
Chemical Properties ◽  
Mechanisms Of Action ◽  
Consumer Products ◽  
Protective Equipment ◽  
Public Places ◽  
Virus Attachment ◽  
Physico Chemical

AbstractViral infections are a serious health challenge, and the COVID-19 pandemic has increased the demand for antiviral measures and treatments for clean surfaces, especially in public places. Here, we review a range of natural and synthetic surface materials and coatings with antiviral properties, including metals, polymers and biopolymers, graphene and antimicrobial peptides, and their underpinning antiviral mechanisms. We also discuss the physico-chemical properties of surfaces which influence virus attachment and persistence on surfaces. Finally, an overview is given of the current practices and applications of antiviral and virucidal materials and coatings in consumer products, personal protective equipment, healthcare and public settings.

#87: Association Between Healthcare-Associated Respiratory Viral Infections and Length of Stay at a Pediatric Hospital

2021 ◽  
Vol 10 (Supplement_1) ◽  
pp. S15-S15
Author(s):  
Zachary Most ◽  
Michael Sebert ◽  
Patricia Jackson ◽  
Trish M Perl
Keyword(s):  
Length Of Stay ◽  
Incubation Period ◽  
Respiratory Infection ◽  
Symptom Onset ◽  
Viral Infections ◽  
Pediatric Hospital ◽  
Time Period ◽  
Life Years ◽  
Respiratory Viral Infections ◽  
Healthcare Associated

Abstract Background Healthcare-associated infections (HAI) are major preventable causes of morbidity and mortality. While there are fewer overall HAI in children, there is a greater potential impact in disability-adjusted life years. Healthcare-associated respiratory viral infections (HARVI) are not frequently tracked within institutions, yet the risk for such infections in pediatric hospitals is very high. Recent data demonstrate large inter-hospital variability of HARVI incidence that may depend on various factors including the number of immunocompromised patients in the hospital and the presence of shared rooms. We hypothesize that the burden of healthcare-associated respiratory viral infections and their impact on the length of stay (LOS) is substantial at a large urban pediatric hospital. Methods A cohort of all children with any HARVI admitted to a large urban pediatric hospital between July 2017 and June 2018 were included after obtaining IRB approval. We defined a HARVI as a respiratory infection with an onset of symptoms while the patient was hospitalized meeting three criteria: A positive microbiologic test for one of 8 viruses, presence of symptoms of a respiratory infection, and onset of symptoms after admission beyond the minimum incubation period for each virus. Infections with symptom onset after admission beyond the maximum incubation period were considered definite hospital onset whereas others were considered possible hospital onset. The electronic medical record provided data on demographics, underlying medical conditions, hospital length of stay prior to infection and hospital unit of infection, and consequences and outcome of HARVI. The at-risk population for calculation of the incidence of HARVI was all admitted patient-days at the hospital over this time period. Results Between July 2017 and June 2018 the incidence of HARVI (definite or possible hospital onset) was 1.2 infections per 1,000 admitted patient-days (60% due to rhinovirus/enterovirus, 12% due to respiratory syncytial virus, and 9% due to influenza). Overall, 48% of patients were under 2 years of age, 18% were between 2 and 5 years of age, and 34% were over 5 years of age. Twenty-one percent were immunocompromised and 35% had underlying lung disease. The median length of stay prior to symptom onset was 11 days (IQR 5–36 days) and the median total length of stay was 30 days (IQR 15–82.5 days). Eight individuals had more than one HARVI over this time period. Nineteen percent were transferred to the intensive care unit and 7% died during their hospital admission Conclusion HARVI occurs frequently in a pediatric hospital and often in patients with underlying comorbidities. The risk for HARVI increases substantially with increased length of stay. Such data support the need for tracking HARVI in high-risk institutions.

Respiratory viruses on personal protective equipment and bodies of healthcare workers

2019 ◽  
Vol 40 (12) ◽  
pp. 1356-1360 ◽  
Author(s):  
Linh T. Phan ◽  
Dagmar Sweeney ◽  
Dayana Maita ◽  
Donna C. Moritz ◽  
Susan C. Bleasdale ◽  
...  
Keyword(s):  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Viral Infections ◽  
Quantitative Polymerase Chain Reaction ◽  
Face Mask ◽  
Respiratory Viruses ◽  
The Body ◽  
Protective Equipment ◽  
Bare Hand ◽  
Polymerase Chain

AbstractObjective:To characterize the magnitude of virus contamination on personal protective equipment (PPE), skin, and clothing of healthcare workers (HCWs) who cared for patients having acute viral infections.Design:Prospective observational study.Setting:Acute-care academic hospital.Participants:A total of 59 HCWs agreed to have their PPE, clothing, and/or skin swabbed for virus measurement.Methods:The PPE worn by HCW participants, including glove, face mask, gown, and personal stethoscope, were swabbed with Copan swabs. After PPE doffing, bodies and clothing of HCWs were sampled with Copan swabs: hand, face, and scrubs. Preamplification and quantitative polymerase chain reaction (qPCR) methods were used to quantify viral RNA copies in the swab samples.Results:Overall, 31% of glove samples, 21% of gown samples, and 12% of face mask samples were positive for virus. Among the body and clothing sites, 21% of bare hand samples, 11% of scrub samples, and 7% of face samples were positive for virus. Virus concentrations on PPE were not statistically significantly different than concentrations on skin and clothing under PPE. Virus concentrations on the personal stethoscopes and on the gowns were positively correlated with the number of torso contacts (P < .05). Virus concentrations on face masks were positively correlated with the number of face mask contacts and patient contacts (P < .05).Conclusions:Healthcare workers are routinely contaminated with respiratory viruses after patient care, indicating the need to ensure that HCWs complete hand hygiene and use other PPE to prevent dissemination of virus to other areas of the hospital. Modifying self-contact behaviors may decrease the presence of virus on HCWs.

scholarly journals 97. Assessment of Personal Protective Equipment Adherence in Red Box Using Remote Video Auditing

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S179-S179
Author(s):  
Vansha Singh ◽  
Akshay Khatri ◽  
Aradhana Khameraj ◽  
Rehana Rasul ◽  
Rebecca Schwartz ◽  
...  
Keyword(s):  
Personal Protective Equipment ◽  
Control Group ◽  
Protective Equipment ◽  
Healthcare Associated Infection ◽  
Contact Isolation ◽  
Sense Of Security ◽  
Close Proximity ◽  
False Sense ◽  
Red Tape ◽  
Healthcare Associated

Abstract Background “Red box (RB)” is a delineated space in the entry way to a patient(pt) room(rm) that facilitates communication between pt and health care provider (HCP) without the latter needing to don/doff personal protective equipment (PPE). It decreases PPE use where unnecessary and increases pt satisfaction ratings. Remote Video Auditing (RVA) is a novel technique used to ensure adherence to isolation precautions. In this study, we used RVA to compare HCP compliance rates with PPE use in isolation rms with or without RB. Methods A prospective observational study (2/26/19-2/27/20) was designed to evaluate HCP compliance with PPE when entering or exiting droplet/contact isolation rms. RB was demarcated by red tape as a 3-ft area at rm entrance, &gt;6 ft from the head of the bed. Cameras were placed at the entry of 4 rms with RB (RB rms) and 2 isolation rms without RB (control rms). Adherence to gowns, gloves, masks and hand hygiene (HH) was reviewed by trained independent remote observers to maintain uniformity. When HCPs stayed in the RB, compliance at exit was calculated. Compliance was compared between events of HCPs going beyond the RB and those of HCPs entering/exiting control rms using binomial regression models with log link. Results RVA captured 6959 pt encounters in 6 rms over a year. Consistent with RB protocol, when HCPs utilized the RB, 69.9% did not practice HH, 91.6% did not utilize gloves and 95.2% did not use gowns (Table 1). When HCPs went beyond the RB, there was significantly increased non-compliance with PPE and HH in RB rms compared with control rms (Table 2). Healthcare-associated infection (HAI) rates for this unit assessed using NHSN criteria demonstrated no increase as compared to prior years. Table 1: Non-Compliance among those who entered Red Box but did not go into the room fully Table 2: Comparison of non-compliance between group that went beyond Red Box Vs. Control group without Red Box Conclusion RVA, a novel, labor-efficient and objective method, was used for observing and comparing PPE compliance in RB rms. Consistent with the purpose of RB, &gt;90% HCPs did not use PPE while confined within it. However, HCPs going beyond the RB were more non-compliant with PPE use as compared to HCPs in control rms. While HAI rates were not increased, this finding is concerning – HCPs going beyond RB may not have used PPE (even in close proximity) due to a false sense of security due to RB. Re-education about optimal use of the RB or discontinuing RB should be considered. Disclosures All Authors: No reported disclosures

scholarly journals 863. Outcomes of Healthcare-Associated Respiratory Viral Infections in a Pediatric Hospital: A Historical Cohort Study

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S470-S470
Author(s):  
Zachary Most ◽  
Patricia Jackson ◽  
Michael Sebert ◽  
Trish M Perl ◽  
Trish M Perl
Keyword(s):  
Intensive Care ◽  
Length Of Stay ◽  
Viral Infections ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Hospital Charges ◽  
Historical Cohort ◽  
Pediatric Hospitals ◽  
Respiratory Viral Infections ◽  
Healthcare Associated

Abstract Background Healthcare-associated respiratory viral infections (HARVI) occur frequently at pediatric hospitals. The spectrum and attributable outcomes of these infections are unknown. Methods Using a matched historical cohort design, HARVI cases identified between July 2013 and June 2018 at a large pediatric referral hospital in Dallas, Texas were defined as patients who tested positive for one of eight respiratory viruses during their hospitalization, had new respiratory symptoms develop during hospitalization, and had symptom onset on a hospitalization day that was greater than the maximum incubation period for the specific respiratory virus. Controls were matched 1:1 for index time, meaning that the control had a hospital length of stay that was at least as long as the length of stay in the matched case prior to viral testing. Controls were also matched for year and month of infection as well as hospital unit and/or age. The primary outcome was additional length of stay following infection or index time. Additional outcomes included transfer to intensive care, need for intubation, hospital charges, and all cause in-hospital mortality. Results Over the 5-year study period, 317 definite HARVI were identified (0.62 per 1,000 admitted patient days), and only 287 (91%) had a matched control to be included in analysis. Among these cases and matched controls, the median time to index time was 19 days (IQR 10-39 days). The most common causative viruses where rhinovirus/enterovirus (188, 65.5%), RSV (30, 10.5%), parainfluenza virus (28, 9.8%), and seasonal coronaviruses (27, 9.4%). Fewer cases than controls were in an intensive care unit at index time (101 [35.2%] vs. 156 [54.4%]) The mean additional length of stay following index time was shorter in cases than controls (35.2 days vs. 48.1 days, difference = -12.9 days, 95% CI -20.95 to -4.82 days). Conclusion Hospital length of stay for cases with HARVI was not longer than for those without HARVI. Possible explanations include confounding and selection bias. Further studies with carefully selected controls are needed. Disclosures All Authors: No reported disclosures

scholarly journals Evaluation of a Redesigned Personal Protective Equipment Gown

2019 ◽  
Vol 69 (Supplement_3) ◽  
pp. S199-S205 ◽  
Author(s):  
Frank A Drews ◽  
Diane Mulvey ◽  
Kristina Stratford ◽  
Matthew H Samore ◽  
Jeanmarie Mayer
Keyword(s):  
Personal Protective Equipment ◽  
User Satisfaction ◽  
Ebola Virus ◽  
Viral Infections ◽  
Cognitive Task ◽  
Healthcare Personnel ◽  
Protective Equipment ◽  
Patient Simulator ◽  
Task Load ◽  
Load Ratings

Abstract Background In healthcare, the goal of personal protective equipment (PPE) is to protect healthcare personnel (HCP) and patients from body fluids and infectious organisms via contact, droplet, or airborne transmission. The critical importance of using PPE properly is highlighted by 2 potentially fatal viral infections, severe acute respiratory syndrome–associated coronavirus and Ebola virus, where HCP became infected while caring for patients due to errors in the use of PPE. However, PPE in dealing with less dangerous, but highly infectious organisms is important as well. This work proposes a framework to test and evaluate PPE with a focus on gown design. Methods An observational study identified issues with potential for contamination related to gown use. After redesigning the existing gown, a high-fidelity patient simulator study with 40 HCP as participants evaluated the gown redesign using 2 commonly performed tasks. Variables of interest were nonadherence to procedural standards, use problems with the gown during task performance, and usability and cognitive task load ratings of the standard and redesigned gowns. Results While no differences were found in terms of nonadherence and use problems between the current and the redesigned gown, differences in usability and task load ratings suggested that the redesigned gown is perceived more favorably by HCP. Conclusions This work proposes a framework to guide the evaluation of PPE. The results suggest that the current design of the PPE gown can be improved in usability and user satisfaction. Although our data did not find an increase in adherence to protocol when using the redesigned gown, it is likely that higher usability and lower task load could result in higher adherence over longer periods of use.

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