scholarly journals Analysis of SteraMist ionized hydrogen peroxide technology in the sterilization of N95 respirators and other PPE: a quality improvement study

2020 ◽  
Author(s):  
Avilash K. Cramer ◽  
Deborah Plana ◽  
Helen Yang ◽  
Mary M. Carmack ◽  
Enze Tian ◽  
...  
Keyword(s):  
Hydrogen Peroxide ◽  
Personal Protective Equipment ◽  
Occupational Safety ◽  
Medical Center ◽  
Academic Medical Center ◽  
Biological Indicator ◽  
Protective Equipment ◽  
Pre Treatment ◽  
Environment Chamber ◽  
N95 Respirators

AbstractObjectiveThe COVID-19 pandemic has led to widespread shortages of personal protective equipment (PPE) for healthcare workers, including filtering facepiece respirators (FFRs) such as N95 masks. These masks are normally intended for single use, but their sterilization and subsequent reuse could substantially mitigate a world-wide shortage.DesignQuality assurance.SettingA sealed environment chamber installed in the animal facility of an academic medical center.InterventionsOne to five sterilization cycles using ionized hydrogen peroxide (iHP), generated by SteraMist® equipment (TOMI; Frederick, MD).Main outcome measuresPersonal protective equipment, including five N95 mask models from three manufacturers, were evaluated for efficacy of sterilization following iHP treatment (measured with bacterial spores in standard biological indicator assemblies). Additionally, N95 masks were assessed for their ability to efficiently filter particles down to 0.3µm and for their ability to form an airtight seal using a quantitative fit test. Filtration efficiency was measured using ambient particulate matter at a university lab and an aerosolized NaCl challenge at a National Institute for Occupational Safety and Health (NIOSH) pre-certification laboratory.ResultsThe data demonstrate that N95 masks sterilized using SteraMist iHP technology retain function up to five cycles, the maximum number tested to date. Some but not all PPE could also be sterilized using an iHP environmental chamber, but pre-treatment with a handheld iHP generator was required for semi-enclosed surfaces such as respirator hoses.ConclusionsA typical iHP environment chamber with a volume of ~80 m3 can treat ~7000 masks per day, as well as other items of PPE, making this an effective approach for a busy medical center.

scholarly journals Analysis of SteraMist ionized hydrogen peroxide technology in the sterilization of N95 respirators and other PPE

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Avilash K. Cramer ◽  
Deborah Plana ◽  
Helen Yang ◽  
Mary M. Carmack ◽  
Enze Tian ◽  
...  
Keyword(s):  
Hydrogen Peroxide ◽  
Healthcare Workers ◽  
Occupational Safety ◽  
Medical Center ◽  
Biological Indicator ◽  
Bacterial Spores ◽  
Safety And Health ◽  
Single Use ◽  
Environment Chamber ◽  
N95 Respirators

AbstractThe COVID-19 pandemic has led to widespread shortages of personal protective equipment (PPE) for healthcare workers, including of N95 masks (filtering facepiece respirators; FFRs). These masks are intended for single use but their sterilization and subsequent reuse has the potential to substantially mitigate shortages. Here we investigate PPE sterilization using ionized hydrogen peroxide (iHP), generated by SteraMist equipment (TOMI; Frederick, MD), in a sealed environment chamber. The efficacy of sterilization by iHP was assessed using bacterial spores in biological indicator assemblies. After one or more iHP treatments, five models of N95 masks from three manufacturers were assessed for retention of function based on their ability to form an airtight seal (measured using a quantitative fit test) and filter aerosolized particles. Filtration testing was performed at a university lab and at a National Institute for Occupational Safety and Health (NIOSH) pre-certification laboratory. The data demonstrate that N95 masks sterilized using SteraMist iHP technology retain filtration efficiency up to ten cycles, the maximum number tested to date. A typical iHP environment chamber with a volume of ~ 80 m3 can treat ~ 7000 masks and other items (e.g. other PPE, iPADs), making this an effective approach for a busy medical center.

scholarly journals Assessment of N95 respirator decontamination and re-use for SARS-CoV-2

2020 ◽  
Author(s):  
Robert J. Fischer ◽  
Dylan H. Morris ◽  
Neeltje van Doremalen ◽  
Shanda Sarchette ◽  
M. Jeremiah Matson ◽  
...  
Keyword(s):  
Hydrogen Peroxide ◽  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Nosocomial Transmission ◽  
Protective Equipment ◽  
Respiratory Protection ◽  
Single Use ◽  
N95 Respirators

The unprecedented pandemic of SARS-CoV-2 has created worldwide shortages of personal protective equipment, in particular respiratory protection such as N95 respirators. SARS-CoV-2 transmission is frequently occurring in hospital settings, with numerous reported cases of nosocomial transmission highlighting the vulnerability of healthcare workers. In general, N95 respirators are designed for single use prior to disposal. Here, we have analyzed four readily available and often used decontamination methods: UV, 70% ethanol, 70C heat and vaporized hydrogen peroxide for inactivation of SARS-CoV-2 on N95 respirators. Equally important we assessed the function of the N95 respirators after multiple wear and decontamination sessions.

Decontamination and Reuse of N95 Respirators with Hydrogen Peroxide Vapor to Address Worldwide Personal Protective Equipment Shortages During the SARS-CoV-2 (COVID-19) Pandemic

2020 ◽  
Vol 25 (2) ◽  
pp. 67-70 ◽  
Author(s):  
Antony Schwartz ◽  
Matthew Stiegel ◽  
Nicole Greeson ◽  
Andrea Vogel ◽  
Wayne Thomann ◽  
...  
Keyword(s):  
Hydrogen Peroxide ◽  
Personal Protective Equipment ◽  
Protective Equipment ◽  
N95 Respirators ◽  
Hydrogen Peroxide Vapor

scholarly journals Understanding Workflow and Personal Protective Equipment Challenges Across Different Healthcare Personnel Roles

2019 ◽  
Vol 69 (Supplement_3) ◽  
pp. S185-S191 ◽  
Author(s):  
Molly Harrod ◽  
Laura Petersen ◽  
Lauren E Weston ◽  
Lynn Gregory ◽  
Jeanmarie Mayer ◽  
...  
Keyword(s):  
Personal Protective Equipment ◽  
Physical Therapists ◽  
Medical Center ◽  
Academic Medical Center ◽  
Geographic Location ◽  
Physical Contact ◽  
Healthcare Personnel ◽  
Protective Equipment ◽  
Effective Strategies ◽  
Field Notes

Abstract Background Hospitals use standard and transmission-based precautions, including personal protective equipment (PPE), to prevent the spread of infectious organisms. However, little attention has been paid to the potentially unique challenges of various healthcare personnel (HCP) in following precaution practices. Methods From September through December 2016, 5 physicians, 5 nurses, and 4 physical therapists were shadowed for 1 hour 30 minutes to 3 hours 15 minutes at an academic medical center. Observers documented activities using unstructured field notes. Focus groups were conducted to better understand HCP perspectives about precautions and PPE-related challenges. Data were analyzed by comparing workflow and challenges (observed and stated) in precaution practices across HCP roles. Results Precaution patients were interspersed throughout physician rounds, which covered a broad geographic range throughout the hospital. Patient encounters were generally brief, and appropriate use of gowns and cleaning of personal stethoscopes varied among observed physicians. Nurses were unit based and frequently entered/exited rooms. Frustration with donning/doffing was especially apparent when needing supplies while in a precaution room, which nurses acknowledged was a time when practice lapses could occur. The observed physical therapists worked in one geographic location, spent extended periods of time with patients, and noted that given their close physical contact with patients, gowns do not fully protect them. Conclusions Movement patterns, time with patients, care activities, and equipment use varied across HCP, leading to a diverse set of challenges in following precaution practices and PPE use. Attention to these differences among HCP is important for understanding and developing effective strategies to prevent the potential spread of infectious organisms.

scholarly journals Assessment of N95 respirator decontamination and re-use for SARS-CoV-2

2020 ◽  
Author(s):  
Robert J. Fischer ◽  
Dylan H. Morris ◽  
Neeltje van Doremalen ◽  
Shanda Sarchette ◽  
Jeremiah Matson ◽  
...  
Keyword(s):  
Hydrogen Peroxide ◽  
Uv Radiation ◽  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Nosocomial Transmission ◽  
Protective Equipment ◽  
Respiratory Protection ◽  
Single Use ◽  
N95 Respirators

The unprecedented pandemic of SARS-CoV-2 has created worldwide shortages of personal protective equipment, in particular respiratory protection such as N95 respirators. SARS-CoV-2 transmission is frequently occurring in hospital settings, with numerous reported cases of nosocomial transmission highlighting the vulnerability of healthcare workers. In general, N95 respirators are designed for single use prior to disposal. Several groups have addressed the potential for re-use of N95 respirators from a mechanical or from a decontamination perspective. Here, we analyzed four different decontamination methods – UV radiation (260 – 285 nm), 70ºC heat, 70% ethanol and vaporized hydrogen peroxide (VHP) – for their ability to reduce contamination with infectious SARS-CoV-2 and their effect on N95 respirator function.

scholarly journals COVID-19 global pandemic planning: Decontamination and reuse processes for N95 respirators

2020 ◽  
Vol 245 (11) ◽  
pp. 933-939 ◽  
Author(s):  
Douglas J Perkins ◽  
Steven Villescas ◽  
Terry H Wu ◽  
Timothy Muller ◽  
Steven Bradfute ◽  
...  
Keyword(s):  
Hydrogen Peroxide ◽  
Operating Room ◽  
Personal Protective Equipment ◽  
Healthcare Personnel ◽  
Protective Equipment ◽  
Environmental Controls ◽  
Creative Solutions ◽  
Increased Risk ◽  
N95 Respirators ◽  
Hydrogen Peroxide Vapor

Coronavirus disease 2019 (COVID-19) is an illness caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The disease was first identified as a cluster of respiratory illness in Wuhan City, Hubei Province, China, in December 2019, and has rapidly spread across the globe to greater than 200 countries. Healthcare providers are at an increased risk for contracting the disease due to occupational exposure and require appropriate personal protective equipment (PPE), including N95 respirators. The rapid worldwide spread of high numbers of COVID-19 cases has facilitated the need for a substantial supply of PPE that is largely unavailable in many settings, thereby creating critical shortages. Creative solutions for the decontamination and safe reuse of PPE to protect our frontline healthcare personnel are essential. Here, we describe the development of a process that began in late February 2020 for selecting and implementing the use of hydrogen peroxide vapor (HPV) as viable method to reprocess N95 respirators. Since pre-existing HPV decontamination chambers were not available, we optimized the sterilization process in an operating room after experiencing initial challenges in other environments. Details are provided about the prioritization and implementation of processes for collection and storage, pre-processing, HPV decontamination, and post-processing of filtering facepiece respirators. Important lessons learned from this experience include, developing an adequate reserve of PPE for effective reprocessing and distribution, and identifying a suitable location with optimal environmental controls (i.e. operating room). Collectively, information presented here provides a framework for other institutions considering decontamination procedures for N95 respirators. Impact statement There is a critical shortage of personal protective equipment (PPE) around the globe. This article describes the safe collection, storage, and decontamination of N95 respirators using hydrogen peroxide vapor (HPV). This article is unique because it describes the HPV process in an operating room, and is therefore, a deployable method for many healthcare settings. Results presented here offer creative solutions to the current PPE shortage.

scholarly journals The Impact of Inpatient Telemedicine on Personal Protective Equipment Savings During the COVID-19 Pandemic: Cross-sectional Study (Preprint)

2021 ◽  
Author(s):  
Reem Halabi ◽  
Geoffrey Smith ◽  
Marc Sylwestrzak ◽  
Brian Clay ◽  
Christopher A Longhurst ◽  
...  
Keyword(s):  
Personal Protective Equipment ◽  
Medical Center ◽  
Academic Medical Center ◽  
Working Environment ◽  
Teaching Hospitals ◽  
Protective Equipment ◽  
Cross Sectional ◽  
Academic Medical ◽  
Telemedicine Technology ◽  
The Impact

UNSTRUCTURED With the emergence of the COVID-19 pandemic and shortage of adequate personal protective equipment (PPE), hospitals implemented inpatient telemedicine measures to ensure operational readiness and a safe working environment for clinicians. The utility and sustainability of inpatient telemedicine initiatives need to be evaluated as the number of COVID-19 inpatients is expected to continue declining. In this viewpoint, we describe the use of a rapidly deployed inpatient telemedicine workflow at a large academic medical center and discuss the potential impact on PPE savings. In early 2020, videoconferencing software was installed on patient bedside iPads at two academic medical center teaching hospitals. An internal website allowed providers to initiate video calls with patients in any patient room with an activated iPad, including both COVID-19 and non–COVID-19 patients. Patients were encouraged to use telemedicine technology to connect with loved ones via native apps or videoconferencing software. We evaluated the use of telemedicine technology on patients’ bedside iPads by monitoring traffic to the internal website. Between May 2020 and March 2021, there were a total of 1240 active users of the Video Visits website (mean 112.7, SD 49.0 connection events per month). Of these, 133 (10.7%) connections were made. Patients initiated 63 (47.4%) video calls with family or friends and sent 37 (27.8%) emails with videoconference connection instructions. Providers initiated a total of 33 (24.8%) video calls with the majority of calls initiated in August (n=22, 67%). There was a low level of adoption of inpatient telemedicine capability by providers and patients. With sufficient availability of PPE, inpatient providers did not find a frequent need to use the bedside telemedicine technology, despite a high census of patients with COVID-19. Compared to providers, patients used videoconferencing capabilities more frequently in September and October 2020. We did not find savings of PPE associated with the use of inpatient telemedicine.

scholarly journals SARS-CoV-2 Infection in Healthcare Personnel and Their Household Contacts at a Tertiary Academic Medical Center: Protocol for a Longitudinal Cohort Study (Preprint)

2020 ◽  
Author(s):  
Emily J Ciccone ◽  
Paul N Zivich ◽  
Evans K Lodge ◽  
Deanna Zhu ◽  
Elle Law ◽  
...  
Keyword(s):  
Risk Factors ◽  
Personal Protective Equipment ◽  
Medical Center ◽  
Academic Medical Center ◽  
Tertiary Care ◽  
Well Being ◽  
Healthcare Personnel ◽  
Protective Equipment ◽  
Household Contacts ◽  
Tertiary Care Medical Center

BACKGROUND Healthcare personnel are at high risk for exposure to the SARS-CoV-2 virus. While personal protective equipment may mitigate this risk, prospective data collection on its use and other risk factors for seroconversion in this population is needed. OBJECTIVE The primary objectives of this study are to (1) determine the incidence of and risk factors for SARS-CoV-2 infection among healthcare personnel at a tertiary medical center and (2) actively monitor personal protective equipment use, interactions between study participants via electronic sensors, secondary cases in households, and participant mental health and well-being. METHODS To achieve these objectives, we designed a prospective, observational study of SARS-CoV-2 infection among healthcare personnel and their household contacts at an academic tertiary care medical center. Enrolled healthcare personnel completed frequent surveys on symptoms and work activities and provided serum and nasal samples for SARS-CoV-2 testing every two weeks. Additionally, interactions between participants and their movement within the clinical environment were captured with a smartphone app and Bluetooth sensors. Finally, a subset of participants' households was randomly selected every two weeks for further investigation, and enrolled households provided serum and nasal samples via at-home collection kits. RESULTS As of September 30, 2020, 164 healthcare personnel and 33 household participants have been enrolled. Recruitment and follow-up are ongoing and expected to continue until March 2021. CONCLUSIONS Much remains to be learned regarding risk of SARS-CoV-2 infection among healthcare personnel and their household contacts. Through use of a multi-faceted study design enrolling a well-characterized cohort, we will collect critical information regarding SARS-CoV-2 transmission in the healthcare setting and its linkage to the community.

scholarly journals Characterization of community-based donation of personal protective equipment to an academic health center during the COVID-19 pandemic

2021 ◽  
Vol 9 (6) ◽  
pp. 33
Author(s):  
Ronda S. Farah ◽  
James T. Pathoulas ◽  
Nathan Rubin ◽  
Lisa M. Hursin ◽  
Molly A. Wyman ◽  
...  
Keyword(s):  
Social Media ◽  
Personal Protective Equipment ◽  
Small Businesses ◽  
Medical Center ◽  
Academic Medical Center ◽  
Protective Equipment ◽  
Academic Medical ◽  
Personal Use ◽  
Building Community ◽  
Novel Coronavirus

Objective: The novel coronavirus 2019 (COVID-19) pandemic led to a shortage of personal protective equipment (PPE) early in the pandemic. Healthcare systems asked for public donations of PPE and established community drop-off sites. Herein, we aim to profile community PPE donors at one large academic medical center including evaluation of donor industry, public messaging, and psychosocial aspects of donation.Methods: A survey was created and distributed to donors at two urban PPE drop-off sites between March and April 2020. Targeted donors and drop-off sites were located in the Twin Cities metropolitan area (approximate population of 3.5 million people).Results: A total of 486 surveys were completed. Nearly half (47.3%) of PPE donated was initially intended for personal use. Donors primarily learned of PPE collection efforts through word of mouth (23.2%) and social media (22.7%). The most frequently reported barrier to donation included distance between donors and drop off sites or location (27.8%). Donors rated the severity of the PPE shortage in the state as a 7.8 ± 1.7 out of 10. There was a slight correlation between donors assessment of COVID-19 severity and feeling that their donation was a meaningful contribution against COVID-19 (r = 0.21, p = .00).Conclusions: Future community collection campaigns during widespread disasters should prioritize mobilizing privately held goods from individuals rather than small businesses. Public messaging around donation should utilize simple narratives that are easily shareable via social media and evoke donation as a means of building community.

scholarly journals Characterization of community-based donation of personal protective equipment to an academic health center during the COVID-19 pandemic

2021 ◽  
Vol 9 (6) ◽  
pp. 34
Author(s):  
Alexandra N. Fuher ◽  
James T. Pathoulas ◽  
Nathan Rubin ◽  
Lisa M. Hursin ◽  
Molly A. Wyman ◽  
...  
Keyword(s):  
Social Media ◽  
Personal Protective Equipment ◽  
Small Businesses ◽  
Medical Center ◽  
Academic Medical Center ◽  
Protective Equipment ◽  
Academic Medical ◽  
Personal Use ◽  
Building Community ◽  
Novel Coronavirus

Objective: The novel coronavirus 2019 (COVID-19) pandemic led to a shortage of personal protective equipment (PPE) early in the pandemic. Healthcare systems asked for public donations of PPE and established community drop-off sites. Herein, we aim to profile community PPE donors at one large academic medical center including evaluation of donor industry, public messaging, and psychosocial aspects of donation.Methods: A survey was created and distributed to donors at two urban PPE drop-off sites between March and April 2020. Targeted donors and drop-off sites were located in the Twin Cities metropolitan area (approximate population of 3.5 million people).Results: A total of 486 surveys were completed. Nearly half (47.3%) of PPE donated was initially intended for personal use. Donors primarily learned of PPE collection efforts through word of mouth (23.2%) and social media (22.7%). The most frequently reported barrier to donation included distance between donors and drop off sites or location (27.8%). Donors rated the severity of the PPE shortage in the state as a 7.8 ± 1.7 out of 10. There was a slight correlation between donors assessment of COVID-19 severity and feeling that their donation was a meaningful contribution against COVID-19 (r = 0.21, p = .00).Conclusions: Future community collection campaigns during widespread disasters should prioritize mobilizing privately held goods from individuals rather than small businesses. Public messaging around donation should utilize simple narratives that are easily shareable via social media and evoke donation as a means of building community.

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