scholarly journals Personal protective equipment use by healthcare workers in intensive care unit during the early phase of COVID-19 pandemic in Italy: a secondary analysis of the PPE-SAFE survey

2021 ◽  
Vol 8 ◽  
pp. 204993612199856
Author(s):  
Mariachiara Ippolito ◽  
Mahesh Ramanan ◽  
Davide Bellina ◽  
Giulia Catalisano ◽  
Pasquale Iozzo ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Secondary Analysis ◽  
International Study ◽  
Western Country ◽  
Protective Equipment ◽  
Occupational Infection ◽  
Significant Difference

Background: Italy was the first Western country to be heavily affected by COVID-19. Healthcare workers (HCWs) were exposed to a high risk of occupational infection, partially due to insufficient personal protective equipment (PPE) supplies. This study aimed to describe the practices, availability, training, confidence in PPE use and the adverse effects due to extended PPE use, as reported by HCWs in Italy. We also aimed to provide a comparison between Italian data and those from other countries. Methods: This study was a secondary analysis of a previously published international study, the PPE-SAFE Survey, conducted in April 2020. Data were analysed from the original study database. Results: We analysed the responses from 380 healthcare workers based in Italy, out of the 2711 respondents to the international survey. Among the Italian respondents, FFP2 and FFP3 respirators or equivalent were the most used masks for routine tasks (respectively 188/380, 50%; and 163/380, 43%). The median time of wearing PPE without taking a break was 5 h [interquartile range (IQR) 4–6], with statistically significant difference from other countries [median 4 h (IQR 2–5) p < 0.0001]. In Italy, 249 out of 380 (65%) HCWs had never performed a formal fit test for a N95 mask or equivalent and 91/380 (24%) never had a partner for donning and doffing procedures. Most of the respondents (299/380, 79%) had received formal training in PPE use at any time. Conclusion: Most of the surveyed Italian HCWs reported working at above usual capacity, long shifts with PPE without breaks and routine use in intensive care unit of aerosol protection (e.g. FFP2/FFP3), hazmat suits and face shields/visors. The correct adherence to safety procedures (e.g. donning/doffing in pairs, performing fit test) has substantial scope for improvement in the future.

scholarly journals Intensive Care Unit Setup for COVID-19

2020 ◽  
Vol 04 (01) ◽  
pp. 05-11
Author(s):  
Shweta Panse ◽  
Muralidhar Kanchi ◽  
Jose Chacko ◽  
Srinath Kumar T. S. ◽  
Ranganatha Ramanjaneya ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Healthcare Workers ◽  
Medical Personnel ◽  
Healthcare Systems ◽  
Protective Equipment ◽  
Cross Contamination ◽  
Ventilator Management ◽  
Coronavirus Infection ◽  
The Ideal

AbstractThe coronavirus pandemic has become a challenge to all the healthcare systems in the world. Urgent creation of an intensive care unit (ICU) for the same is the need of the hour. The ideal ICU for COVID -19 should be isolated, fully equipped with invasive and noninvasive monitoring, with 24/7 trained medical personnel, nursing staff and laboratory support. As the coronavirus infection is transmitted by droplets and is highly contagious, protection of healthcare workers is crucial. Personnel working inside the ICU should get personal protective equipment (PPE). Strict guidelines for donning and doffing of PPE should be followed to prevent cross-contamination. Respiratory failure being the commonest complication of COVID-19, knowing the ventilator management for the same is essential. It is of great importance to meticulously manage all the resources to combat this contagion.

scholarly journals 70 Availability of Personal Protective Equipment in NHS Hospitals During COVID-19: A National Survey

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
A Mantelakis ◽  
H Spiers ◽  
C W Lee ◽  
A Chambers ◽  
A Joshi
Keyword(s):  
Intensive Care ◽  
Personal Protective Equipment ◽  
Healthcare Professionals ◽  
Protective Equipment ◽  
Professional Groups ◽  
Safe Level ◽  
Significant Difference ◽  
The Uk ◽  
Question Survey ◽  
Full Body

Abstract Introduction The continuous supply of personal protective equipment (PPE) in the National Health Service (NHS) is paramount in order to sustain a safe level of staffing and to reduce transmission of COVID-19 to patients, public and staff. Method A 16-question survey was created to assess the availability and personal thoughts of healthcare professionals regarding PPE supply in England. The survey was distributed via social media (Facebook © and Twitter ©) to all UK COVID-19 healthcare professional groups, with responses collected over 3 weeks in March 2020 during the beginning of the pandemic. Results A total of 121 responses from physicians in 35 different hospitals were collected (105 inpatient wards, 16 from intensive care units). In inpatient wards, eye and face protection were unavailable to 19.1% of respondents. Masks were available to 97.7% of respondents and gloves in all respondents (100%). Body protection was available primarily as a plastic apron (83.8%). All of respondents working in intensive care had access to full-body PPE, except FFP3 respirator masks (available in 87.5%). PPE is ‘Always’ available for 29.8% of all respondents, and ‘Never’ or ‘Almost Never’ in 11.6%. There was a statistically significant difference between London and non-London responders that ‘Always’ had PPE available (43.9% versus 19.0%, p = 0.003). Conclusions This is the first survey to evaluate PPE supply in England during the COVID-19 pandemic. Our survey demonstrated an overall lack of PPE volume supply in the UK, with preferential distribution in London. Eye and full body protection are in most lack of supply.

DELIVERING INTENSIVE CARE TO COVID-19 PATIENTS WHILE PROTECTING THEMSELVES: CHALLENGES FACED BY FRONT LINE ANAESTHESIOLOGISTS

2021 ◽  
pp. 19-21
Author(s):  
Monica Chhikara ◽  
Prashant Kumar ◽  
Priyanka Bansal ◽  
Reena Mahajan ◽  
Preeti Gehlaut ◽  
...  
Keyword(s):  
Intensive Care ◽  
Airway Management ◽  
Intensive Care Units ◽  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Protective Equipment ◽  
Front Line ◽  
Central Venous ◽  
Cross Sectional ◽  
Junior Residents

Background and Objectives: Frontline anaesthesiologist working in Covid 19 Intensive care units are the key to the management and containment of this infectious disease. Hence, their protection is of utmost importance in managing this epidemic. The equipment used for this purpose, pose technical difculties. This study is a survey of these challenges faced by anaesthesiologists. Material and Methods: This is a descriptive, cross sectional questionnaire based study which included 67 Anesthesiologist junior residents, senior residents and consultants. A valid Google form Questionnaire regarding technical difculties due to use of personal protective equipment was prepared and sent online to all participants. The responses were recorded and tabulated. Results: Physical fatigue due to PPE was experienced by 36(53.7%) residents and difculties in airway management by 66(98.5%) residents. Fogging of goggles was the major difculty (52.2%) during airway management. Intubation while using only PPE (71.6%) was a preferred method of intubation rather than using acrylic box (4.5%) or transparent sheet (23.9%). Apart from managing airway, other procedures like central venous cannulation was found to be always difcult (23.9%). Training program for managing pandemic was found to be helpful and 70.1% residents expressed the need for its conduct before every posting. Conclusion: Managing Covid 19 patients in a highly demanding area like intensive care units while using personal protective equipment has unveiled special challenges and concerns for frontline anaesthesiologists. Addressing them appropriately is the need of hour for the wellbeing of healthcare workers and effective patient management.

scholarly journals Access to personal protective equipment in healthcare workers during the COVID-19 pandemic in the United Kingdom: results from a nationwide cohort study (UK-REACH)

2021 ◽  
Author(s):  
Christopher A Martin ◽  
Daniel Pan ◽  
Joshua Nazareth ◽  
Avinash Aujayeb ◽  
Luke Bryant ◽  
...  
Keyword(s):  
Cohort Study ◽  
United Kingdom ◽  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Secondary Analysis ◽  
Protective Equipment ◽  
Primary Analysis ◽  
Questionnaire Response ◽  
The United Kingdom ◽  
The Uk

Abstract Objectives: To determine the prevalence and predictors of self-reported access to appropriate personal protective equipment (aPPE) for healthcare workers (HCWs) in the United Kingdom (UK) during the first UK national COVID-19 lockdown (March 2020) and at the time of questionnaire response (December 2020 - February 2021). Design: Two cross sectional analyses using data from a questionnaire-based cohort study. Setting: Nationwide questionnaire from 4th December 2020 to 28th February 2021. Participants: A representative sample of HCWs or ancillary workers in a UK healthcare setting aged 16 or over, registered with one of seven main UK healthcare regulatory bodies. Main outcome measure: Binary measure of self-reported aPPE (access all of the time vs access most of the time or less frequently) at two timepoints: the first national lockdown in the UK (primary analysis) and at the time of questionnaire response (secondary analysis). Results: 10,508 HCWs were included in the primary analysis, and 12,252 in the secondary analysis. 3702 (35.2%) of HCWs reported aPPE at all times in the primary analysis; 6806 (83.9%) reported aPPE at all times in the secondary analysis. After adjustment (for age, sex, ethnicity, migration status, occupation, aerosol generating procedure exposure, work sector, work region, working hours, night shift frequency and trust in employing organisation), older HCWs (per decade increase in age: aOR 1.2, 95% CI 1.16 - 1.26, p<0.001) and those working in Intensive Care Units (1.61, 1.38 - 1.89, p<0.001) were more likely to report aPPE at all times. Those from Asian ethnic groups compared to White (0.77, 0.67 - 0.89, p<0.001), those in allied health professional (AHPs) and dental roles (vs those in medical roles; AHPs: 0.77, 0.68 - 0.87, p<0.001; dental: 0.63, 0.49 - 0.81, p<0.001), and those who saw a higher number of COVID-19 patients compared to those who saw none (≥21 patients 0.74, 0.61 - 0.90, p=0.003) were less likely to report aPPE at all times in the primary analysis. aPPE at all times was also not uniform across UK regions (reported access being better in South West and North East England than London). Those who trusted their employing organisation to deal with concerns about unsafe clinical practice, compared to those who did not, were twice as likely to report aPPE at all times (2.18, 1.97 - 2.40, p<0.001). With the exception of occupation, these factors were also significantly associated with aPPE at all times in the secondary analysis. Conclusions: We found that only a third of HCWs in the UK reported aPPE at all times during the period of the first lockdown and that aPPE had improved later in the pandemic. We also identified key sociodemographic and occupational determinants of aPPE during the first UK lockdown, the majority of which have persisted since lockdown was eased. These findings have important public health implications for HCWs, particularly as cases of infection and long-COVID continue to rise in the UK.

scholarly journals COVID-19: lessons for junior doctors redeployed to critical care

2020 ◽  
pp. postgradmedj-2020-138100 ◽  
Author(s):  
Charles Coughlan ◽  
Chaitanya Nafde ◽  
Shaida Khodatars ◽  
Aimi Lara Jeanes ◽  
Sadia Habib ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Human Resources ◽  
Personal Protective Equipment ◽  
Moral Injury ◽  
Protective Equipment ◽  
Junior Doctors ◽  
Surge Capacity ◽  
Relative Lack

Approximately 4% of patients with coronavirus disease 2019 (COVID-19) will require admission to an intensive care unit (ICU). Governments have cancelled elective procedures, ordered new ventilators and built new hospitals to meet this unprecedented challenge. However, intensive care ultimately relies on human resources. To enhance surge capacity, many junior doctors have been redeployed to ICU despite a relative lack of training and experience. The COVID-19 pandemic poses additional challenges to new ICU recruits, from the practicalities of using personal protective equipment to higher risks of burnout and moral injury. In this article, we describe lessons for junior doctors responsible for managing patients who are critically ill with COVID-19 based on our experiences at an urban teaching hospital.

scholarly journals Protecting healthcare workers during the COVID-19 pandemic: Australian results from the PPE-SAFE survey.

2020 ◽  
Author(s):  
Mahesh Ramanan ◽  
Alexis Tabah ◽  
Kevin Laupland
Keyword(s):  
Adverse Effect ◽  
Intensive Care ◽  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Significant Proportion ◽  
Protective Equipment ◽  
The World ◽  
Fit Testing ◽  
Single Use ◽  
Current Practices

The COVID-19 pandemic has led to global shortages of personal protective equipment (PPE). Healthcare workers (HCW) have comprised a significant proportion of COVID-19 cases in many countries. The PPE-SAFE survey was conducted to study current practices, availability, shortages, training and confidence in PPE amongst intensive care HCWs around the world. Herein, we describe the results of the Australian respondents to the PPE-SAFE survey. 29% of respondents reported that at least one item of usually available PPE was missing, and 12% reported reuse of single-use items. Only 40% felt that the PPE available to them offered adequate protection. Fit-testing of respirators had never been performed for 47% of respondents, and 49% reported at least one adverse effect from the use of PPE.

scholarly journals Sociodemographic and Clinical Features of COVID-19 Reinfection Cases Among Healthcare Workers in Turkey

2021 ◽  
Author(s):  
Hatice İkiışık ◽  
Yasemin Çağ ◽  
Mehmet Akif Sezerol ◽  
Aral Surmeli ◽  
Yusuf Taşçı ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
World Health ◽  
Protective Equipment ◽  
Online Questionnaire ◽  
Global Pandemic ◽  
Novel Coronavirus ◽  
Health Organization ◽  
Disease Characteristic

Abstract Background: Global pandemic of novel Coronavirus Disease (SARS- COV-2) has spread across all continents and infected almost 80 million people. Since it is a novel disease, unknowns about the disease characteristic, treatment and length of immunity still persist. This study aims to characterize reinfection, personal protective equipment use and disease progress in healthcare workers in İstanbul. Methods: 23 healthcare workers who had confirmed negative PCR results after infection and another positivity later were questioned about both infection progress, their symptoms and treatment through an online questionnaire. Results: While the symptoms during both courses did not change drastically, 73.9% were treated as outpatient during the first infection while all but one (95.7%) were treated as such during second time around. Median time between two infections were 106 days. All participants were cleared of disease and none had to be treated in intensive care unit. Conclusion: Use of personal protective equipment was found subpar compared to World Health Organization recommendations. This is the first study from Turkey characterizing reinfected cases in healthcare workers.

scholarly journals Availability of Personal Protective Equipment in NHS Hospitals During COVID-19: A National Survey

2020 ◽  
Author(s):  
Angelos Mantelakis ◽  
Harry V M Spiers ◽  
Chang Woo Lee ◽  
Alastair Chambers ◽  
Anil Joshi
Keyword(s):  
Intensive Care ◽  
Personal Protective Equipment ◽  
Healthcare Professionals ◽  
Protective Equipment ◽  
Professional Groups ◽  
Surgical Masks ◽  
Significant Difference ◽  
The Uk ◽  
Question Survey ◽  
Full Body

Abstract Objectives The continuous supply of personal protective equipment (PPE) in the National Health Service (NHS) is paramount to reduce transmission of COVID-19 to patients, public, and staff. Methods A 16-question survey was created to assess the availability and personal thoughts of healthcare professionals regarding PPE supply in England. The survey was distributed via social media (Facebook© and Twitter©) to UK COVID-19 healthcare professional groups, with responses collected over 3 weeks in March 2020 during the beginning of the pandemic. Results A total of 121 responses from physicians in 35 different hospitals were collected (105 inpatient wards, 16 from intensive care units). In inpatient wards, eye and face protection were unavailable to 19% (20/105). Fluid-resistant surgical masks were available to 97% (102/105) whereas filtering facepiece class 3 (FFP3) respirator for 53% (56/105) of respondents. Gloves were accessible for all respondents (100%). Body protection was available primarily as a plastic apron 84% (88/105). All of respondents working in intensive care had access to full-body PPE, except FFP3 respirators (available in 88%, 14/16). PPE is ‘Always’ available for 30% (36/121) of all respondents. There was a statistically significant difference between London and non-London respondents that ‘Always’ had PPE available (44 versus 19%, P = 0.003). Conclusions Our survey demonstrated an overall lack of PPE volume supply in the UK hospitals during March 2020, demonstrating a lack of preparedness for a pandemic. PPE was more readily available in London which was the epicentre of the outbreak. Eye and full body protection are in most lack of supply.

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