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 Trends in personal protective equipment use by clinicians performing airway procedures for patients with coronavirus disease 2019 in the USA from the intubateCOVID registry

2021 ◽  
Vol 126 (5) ◽  
pp. e184-e186
Author(s):  
Timothy G. Gaulton ◽  
Mark D. Neuman ◽  
Timothy Gaulton ◽  
Mark Neuman ◽  
Meghan Lane-Fall ◽  
...  
Keyword(s):  
Personal Protective Equipment ◽  
Protective Equipment ◽  
The Usa

Respiratory protection ‒ new challenges

2021 ◽  
Vol 70 (1) ◽  
pp. 129-153
Author(s):  
Władysław Harmata ◽  
Dorota Kamionek
Keyword(s):  
Air Pollution ◽  
Particulate Matter ◽  
Personal Protective Equipment ◽  
Virus Transmission ◽  
Protective Equipment ◽  
Respiratory Protection ◽  
Protection Measures ◽  
Normative Requirements ◽  
New Challenges

The paper characterizes the problem of air pollution with smog. The possibility of SARS-CoV-2 virus transmission on particulate matter and the possibility of infection was analyzed. Individual respiratory protection measures available on the market were analyzed in terms of mass use, taking into account legal and normative requirements. Keywords: personal protective equipment, respiratory protection

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.

Safety and Efficacy of DEET and Permethrin in the Prevention of Arthropod Attack

1998 ◽  
Vol 163 (5) ◽  
pp. 324-330 ◽  
Author(s):  
G. David Young ◽  
Sandra Evans
Keyword(s):  
Occupational Health ◽  
Infectious Diseases ◽  
Personal Protective Equipment ◽  
Synthetic Pyrethroid ◽  
Protective Equipment ◽  
Insect Repellent ◽  
First Line ◽  
Protective Measures ◽  
Safety And Efficacy ◽  
Protective Strategy

Abstract Many preventable diseases affecting troop strength are directly attributed to disease-carrying insects. The first line of defense against arthropod vectors is the use of personal protective measures. The concurrent application of DEET (N,N-diethyl-m-toluamide) repellent on the skin and permethrin [(3-phenoxy-phenyl)methyl(±)cis,trans-3-(2,2-dichloroethenyl)-2,2-dimethylcyclopropane-carboxylate] insecticide on the battle dress uniform, while the uniform is worn properly, is a personal protective strategy officially known as the DOD Insect Repellent System. It is important for troop commanders and field leaders to enforce the use of personal protective measures to prevent insect-borne infectious diseases and to ensure troop and soldier readiness. DEET is a safe and effective repellent. Permethrin is a synthetic pyrethroid insecticide and repellent. Used in conjunction with proper clothing and other personal protective equipment, these repellents provide the best known protection available and are critical in minimizing the occupational health threat of arthropod-borne diseases to troops in the field.

scholarly journals Management of used personal protective equipment and wastes related to COVID-19 in South Korea

2020 ◽  
Vol 38 (8) ◽  
pp. 820-824 ◽  
Author(s):  
Seung-Whee Rhee
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Infectious Diseases ◽  
South Korea ◽  
Personal Protective Equipment ◽  
Ebola Virus ◽  
Protective Equipment ◽  
Management Process ◽  
Safe Management ◽  
Rapid Spread ◽  
Management Method

With the rapid spread of coronavirus disease 2019 (COVID-19), the amount of used personal protective equipment (PPE) including face masks and protective clothes has significantly increased. This used PPE in a hospital can lead to the indirect infection by COVID-19. Accordingly, it has been recognized that the management of used PPE is very important to prevent the spread of COVID-19. Through the experience of spreading some infectious diseases such as severe acute respiratory syndrome, Middle East respiratory syndrome and Ebola virus in South Korea (Republic of Korea), a safe management method of waste related to infectious diseases has been developed. In addition, regarding waste related to COVID-19, the Ministry of Environment, SK, proposed special measures to strengthen the management process of waste related to COVID-19 based on principles such as sustainability, transparency and safety.

Personal Protective Equipment Management and Policies: European Network for Highly Infectious Diseases Data from 48 Isolation Facilities in 16 European Countries

2012 ◽  
Vol 33 (10) ◽  
pp. 1008-1016 ◽  
Author(s):  
Giuseppina De Iaco ◽  
Vincenzo Puro ◽  
Francesco Maria Fusco ◽  
Stefan Schilling ◽  
Helena C. Maltezou ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Personal Protective Equipment ◽  
European Countries ◽  
Assessment Process ◽  
Positive Pressure ◽  
Protective Equipment ◽  
Sudden Increase ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Isolation Facilities

Objective.To collect data about personal protective equipment (PPE) management and to provide indications for improving PPE policies in Europe.Design.Descriptive, cross-sectional survey.Setting and Participants.Data were collected in 48 isolation facilities in 16 European countries nominated by National Health Authorities for the management of highly infectious diseases (HIDs).Methods.Data were collected through standardized checklists at on-site visits during February-November 2009. Indications for adequate PPE policies were developed on the basis of a literature review, partners' expert opinions, and the collected data.Results.All facilities have procedures for the selection of PPE in case of HID, and 44 have procedures for the removal of PPE. In 40 facilities, different levels of PPE are used according to a risk assessment process, and in 8 facilities, high-level PPE (eg, positive-pressure complete suits or Trexler units) is always used. A fit test is performed at 25 of the 40 facilities at which it is applicable, a seal check is recommended at 25, and both procedures are used at 17. Strategies for promoting and monitoring the correct use of PPE are available at 42 facilities. In case of a sudden increase in demand, 44 facilities have procedures for rapid supply of PPE, whereas 14 facilities have procedures for decontamination and reuse of some PPE.Conclusions.Most isolation facilities devote an acceptable level of attention to PPE selection and removal, strategies for the promotion of the correct use of PPE, and ensuring adequate supplies of PPE. Fit test and seal check procedures are still not widely practiced. Moreover, policies vary widely between and within European countries, and the development of common practice procedures is advisable.Infect Control Hosp Epidemiol 2012;33(10):1008-1016

scholarly journals Which Personal Protective Equipment Should I Use while Caring for Children Attending the ED? Paediatric Emergency Procedures in the COVID-19 Era and Beyond

2021 ◽  
Author(s):  
Simon Craig ◽  
Julia Clark ◽  
Mike Starr ◽  
Joanne Grindlay ◽  
Andrew Tagg ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Infectious Diseases ◽  
Personal Protective Equipment ◽  
Respiratory Illness ◽  
Transmission Risk ◽  
Protective Equipment ◽  
Emergency Physicians ◽  
Emergency Procedures ◽  
Community Transmission ◽  
Infectious Disease Specialists

Abstract ObjectivesTo determine recommendations for the use of personal protective equipment (PPE) based on transmission risk for paediatric procedures in the Emergency Department during the COVID-19 pandemic. MethodsTwo survey rounds were conducted in April-May 2020. The survey presented a number of emergency medicine procedures relevant to the care of children, and asked respondents to provide PPE recommendations according to levels of community transmission, and whether or not the child had symptoms of acute respiratory illness. ResultsParticipants were recruited by approaching relevant professional groups, with 15 from the PREDICT network and 12 from the Australasian Society of Infectious Diseases (ASID) Paediatric Infectious Diseases (ANZPID) Group. Airborne PPE is recommended for resuscitative procedures and various respiratory procedures in most situations There were differences in opinion between emergency and paediatric infectious disease specialists with regards to most appropriate PPE for children without symptoms of COVID-19 in a setting of low community transmission, and for procedures involving the head, neck or airway. In general, emergency physicians were more likely to favour airborne PPE than infectious disease specialists. In the setting of high community transmission, there was a stronger tendency to recommend at least droplet precautions for most procedures – regardless of whether or not the child had symptoms. ConclusionsDifferences in PPE recommendations for various paediatric procedures between infectious disease specialists and emergency physicians were identified. Further research is urgently needed to clarify and quantify risks for many common interventions and determine strategies for multidisciplinary consensus regarding future recommendations.

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