scholarly journals Spectrum of HRCT findings among asymptomatic and recovered COVID-19 patients: how did they impact the clinical decision?

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Ahmed Samir ◽  
Mohamed Saied Abdelgawad ◽  
Ayman Ibrahim Baess ◽  
Hebatallah Hassan Mamdouh Hassan
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Lung Volume ◽  
Personal Protective Equipment ◽  
Clinical Decision ◽  
Protective Equipment ◽  
Care Providers ◽  
Initial Screening ◽  
Expert Consultant ◽  
Spread Of Infection

Abstract Background Decisions about asymptomatic COVID-19 patients are always critical, either during initial screening or during recovery. Spread of infection will be inevitable if those patients were left non-isolated. This study aimed not only to survey spectrum of HRCT findings of COVID-19 among asymptomatic and recovered patients but also to record unexpected results and document their impact upon the clinical decision. Results The study was retrospectively conducted, during June and July 2020, on 120 patients proved with COVID-19, during initial HRCT screening or delayed following announcement of recovery. All patients were completely asymptomatic. They included 72 males and 48 females (60%:40%). Their age ranged from 10 to 58 years (mean 35.95 ± 12.25 SD). HRCT was analyzed by three expert consultant radiologists in consensus. Among asymptomatic initially screened COVID-19 patients, additional to GGOs, bilateral consolidative changes were unexpectedly found together with secondary fibrosis (23.3% and 10%). HRCT results significantly impacted the clinical decision (P < 0.0001); PCR had to be repeated with home isolation (43.3%). Infected health care providers had to stop their duty immediately (20%). Isolated hospitalization replaced routine ward admission (25%). Cautious surgical interference was performed using full personal protective equipment (PPE) (8.3%). Among asymptomatic recovered COVID-19 patients, unexpected large lesions (> 3 cm) were found (70%). Near 50% of lung volume was persistently affected (10%). Secondary fibrosis was striking (33%). Encysted hydro-pneumothorax persisted for a whole month (1.7%). “No-isolation” decision remained unchanged because of clinical and laboratory stability; however, steroids were prescribed to speed lung recovery. Conclusion HRCT findings among asymptomatic and recovered COVID-19 patients can be unexpected and can definitely impact the clinical decision.

scholarly journals Preventing Facial Pressure Injury for Health Care Providers Adhering to COVID-19 Personal Protective Equipment Requirements

2020 ◽  
Vol 33 (8) ◽  
pp. 418-427 ◽  
Author(s):  
Hiske Smart ◽  
Francis Byron Opinion ◽  
Issam Darwich ◽  
Manal Aly Elnawasany ◽  
Chaitanya Kodange
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Personal Protective Equipment ◽  
Protective Equipment ◽  
Care Providers ◽  
Pressure Injury

scholarly journals Adverse effects of prolonged use of personal protective equipment among health care workers during COVID-19 pandemic

2021 ◽  
Vol 8 (9) ◽  
pp. 4400
Author(s):  
Subhash Chand ◽  
Neeraj Sharma ◽  
Sanjay Kumar
Keyword(s):  
Health Care ◽  
Adverse Effects ◽  
Health Care Providers ◽  
Health Care Workers ◽  
Personal Protective Equipment ◽  
Healthcare Providers ◽  
Protective Equipment ◽  
Care Providers ◽  
Care Workers ◽  
Almost All

Background: To know adverse effects of prolonged use of (PPE) personal protective equipment among various categories of health care providers while taking care of COVID-19 patients.Methods: This study include health care workers involved in care of covid-19 positive patients admitted in COVID dedicated hospital. A preformed questionnaire based performa was distributed among health care providers. Questions were framed about various possible adverse effects of use of PPE. Duration of study was six month from first July 2020 to 31 December 2020. The data was obtained from questionnaire and thereafter analysed to determine the adverse effects of different parts of PPE among various categories of HCPs depending on their age, sex and duration of exposure.Results: A total of 150 health care workers of various categories were surveyed. Maximum numbers of health care workers were in the age group of 31-40 years. Most common side effects were itching, rash, suffocation and impaired cognition. N-95 masks, gloves and face shield when used caused maximum discomfort.Conclusions: COVID-19 is ongoing pandemic with uncertinity about its end. Health care workers are continuously exposed to COVID-19 positive patients and almost all the healthcare providers experienced discomfort while using PPE causing reduced work efficiency.

scholarly journals COVID-19: Repeated video-watching vs. combined video-watching and live demonstration as training to health care providers for donning and doffing personal protective equipment

2020 ◽  
Author(s):  
Yongxing Li ◽  
Yong Wang ◽  
Yuhui Li ◽  
Ming Zhong ◽  
Huihui Liu ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Workers ◽  
Personal Protective Equipment ◽  
Protective Equipment ◽  
Care Providers ◽  
Care Workers ◽  
Live Demonstration ◽  
Group A ◽  
Group B

Abstract Background During the COVID-19 pandemic, not only was there a lack of personal protective equipment (PPE) for health care workers but a dearth in training in respect of its donning and doffing. This study compared two training methods for donning and doffing PPE in order to teach health care workers how to do so more effectively and quickly. Method A total of 48 health care workers were recruited and randomly divided into two groups. Group A watched a 10-minute demonstration (demo) video repeated four times, while Group B watched the same demo video twice followed by a 10-minute live demo twice. The learning time of both groups was the same, and an examination was performed immediately after the completion of training. The examination scores of Group A and Group B were recorded according to the checklist (Appendix 1). The time taken for the participants to don and doff PPE, their satisfaction with the training, and the confidence to don and doff PPE were analyzed. Results The average score of Group B was better than that of Group A, with a mean (SD) of 94.92 (1.72) vs. 86.63 (6.34), respectively (P < 0.001). The average time spent by Group B to do the examination was shorter than that of Group A, with a mean (SD) of 17.67 (1.01) vs. 21.75 (1.82), respectively (P < 0.001). The satisfaction and confidence of Group B were higher than those of group A (P < 0.001). Conclusions Compared with repeated video-watching learning, the video-watching plus a live demonstration teaching method is more suitable for health care workers to learn how to put on and remove personal protective equipment.

scholarly journals A study on personal protective equipment use among health care providers, Tamil Nadu

2018 ◽  
Vol 5 (5) ◽  
pp. 1771 ◽  
Author(s):  
Archana Lakshmi P. A. ◽  
Gladius Jennifer H. ◽  
Meriton Stanly A. ◽  
Christina Mary Paul
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Personal Protective Equipment ◽  
Tamil Nadu ◽  
Cross Sectional Study ◽  
Protective Equipment ◽  
Care Providers ◽  
Appropriate Use ◽  
Cross Sectional ◽  
Inappropriate Use

Background: Personal protective equipment (PPE) limits the health care workers contact with all secretions or biological products. This study was planned to find gaps between use of PPE among the health care providers (HCPs). The objective of the study was to evaluate appropriate use of PPE among health care providers in tertiary centres Tamil Nadu.Methods: A cross sectional study was done during November 2014 to October 2015 in two tertiary health care institutions. All health care providers (Doctors, nurses and technicians) who had more than one year experience and gave informed consent were included. Data collected by pretested structured questionnaire. Data analysis was done using SPSS 20v and summarized by descriptive statistics. Proportion and Chi-square was calculated at 5% α.Results: HCPs included in the study were 1060. Among them, there were 412(38.9%) doctors, 550 (51.9%) nurses and 98 (9.2%) technicians. Among 862 HCPs who work outside the operation theatre (OT) and ICU, appropriate uses of PPE were only 156 (18.1%). It was high among doctors 109 (31.5%) followed by nurses 39 (9.3%) and technicians 8 (8.2%) which was statistically significant p=0.0001. HCPs working in OT and ICU were 423 and 183 respectively. Among HCPs working in OT, appropriate use of gloves, mask, apron, gown and hair cover was 100%. But the use of goggles and shoe cover was very low. The reasons for inappropriate use of PPE was non availability 562 (78%) followed by not aware of the importance 77 (11%).Conclusions: The study showed inappropriate use and lack of adequate knowledge on infection control practices emphasizing that periodic re-training is needed. 

Consent, Refusal, and Waivers in Patient-Centered Dysphagia Care: Using Law, Ethics, and Evidence to Guide Clinical Practice

2016 ◽  
Vol 25 (4) ◽  
pp. 453-469 ◽  
Author(s):  
Jennifer Horner ◽  
Maria Modayil ◽  
Laura Roche Chapman ◽  
An Dinh
Keyword(s):  
Health Care ◽  
Public Policy ◽  
Clinical Practice ◽  
Health Care Providers ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Care Providers ◽  
Patient Centered ◽  
Legal Advice ◽  
Medical Context

PurposeWhen patients refuse medical or rehabilitation procedures, waivers of liability have been used to bar future lawsuits. The purpose of this tutorial is to review the myriad issues surrounding consent, refusal, and waivers. The larger goal is to invigorate clinical practice by providing clinicians with knowledge of ethics and law. This tutorial is for educational purposes only and does not constitute legal advice.MethodThe authors use a hypothetical case of a “noncompliant” individual under the care of an interdisciplinary neurorehabilitation team to illuminate the ethical and legal features of the patient–practitioner relationship; the elements of clinical decision-making capacity; the duty of disclosure and the right of informed consent or informed refusal; and the relationship among noncompliance, defensive practices, and iatrogenic harm. We explore the legal question of whether waivers of liability in the medical context are enforceable or unenforceable as a matter of public policy.ConclusionsSpeech-language pathologists, among other health care providers, have fiduciary and other ethical and legal obligations to patients. Because waivers try to shift liability for substandard care from health care providers to patients, courts usually find waivers of liability in the medical context unenforceable as a matter of public policy.

scholarly journals Evaluation of User-Interface Alert Displays for Clinical Decision Support Systems for Sepsis

2018 ◽  
Vol 38 (4) ◽  
pp. 46-54 ◽  
Author(s):  
Devida Long ◽  
Muge Capan ◽  
Susan Mascioli ◽  
Danielle Weldon ◽  
Ryan Arnold ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Support ◽  
User Interface ◽  
Decision Support Systems ◽  
Clinical Decision Support ◽  
Health Care Providers ◽  
Support Systems ◽  
Clinical Decision Support Systems ◽  
Clinical Decision ◽  
Care Providers

BACKGROUND Hospitals are increasingly turning to clinical decision support systems for sepsis, a life-threatening illness, to provide patient-specific assessments and recommendations to aid in evidence-based clinical decision-making. Lack of guidelines on how to present alerts has impeded optimization of alerts, specifically, effective ways to differentiate alerts while highlighting important pieces of information to create a universal standard for health care providers. OBJECTIVE To gain insight into clinical decision support systems–based alerts, specifically targeting nursing interventions for sepsis, with a focus on behaviors associated with and perceptions of alerts, as well as visual preferences. METHODS An interactive survey to display a novel user interface for clinical decision support systems for sepsis was developed and then administered to members of the nursing staff. RESULTS A total of 43 nurses participated in 2 interactive survey sessions. Participants preferred alerts that were based on an established treatment protocol, were presented in a pop-up format, and addressed the patient’s clinical condition rather than regulatory guidelines. CONCLUSIONS The results can be used in future research to optimize electronic medical record alerting and clinical practice workflow to support the efficient, effective, and timely delivery of high-quality care to patients with sepsis. The research also may advance the knowledge base of what information health care providers want and need to improve the health and safety of their patients.

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