scholarly journals Barrier Devices, Intubation, and Aerosol Mitigation Strategies: Personal Protective Equipment in the Time of Coronavirus Disease 2019

2020 ◽  
Vol 132 (1) ◽  
pp. 38-45
Author(s):  
Eric A. Fried ◽  
George Zhou ◽  
Ronak Shah ◽  
Da Wi Shin ◽  
Anjan Shah ◽  
...  
Keyword(s):  
Personal Protective Equipment ◽  
Mitigation Strategies ◽  
Protective Equipment

Management of personal protective equipment during the COVID-19 pandemic in England and the state of New York: A comparative case study

2020 ◽  
Vol 18 (7) ◽  
pp. 71-89
Author(s):  
Amy Barber, BSc ◽  
Annaëlle Vinzent, BS ◽  
Imani Williams, BA
Keyword(s):  
New York ◽  
Supply Chain ◽  
Health Systems ◽  
Personal Protective Equipment ◽  
New York State ◽  
The United States ◽  
Mitigation Strategies ◽  
Comparative Case Study ◽  
Protective Equipment

Background: The COVID-19 crisis placed extraordinary demands on the supply of personal protective equipment (PPE) at the beginning of 2020. These were coupled with shocks to the supply chain resulting from the disease. Many typically well-resourced health systems faced subsequent shortages of equipment and had to implement new strategies to manage their stocks. Stockpiles of protective equipment were held in both the United States and United Kingdom intended to prevent shortages. Method: Cross-comparative case study approach by applying Pettigrew and Whipp’s framework for change management. Setting: The health systems of England and New York state from January 2020 to the end of April 2020. Results: Both cases reacted slowly to their outbreaks and faced problems with supplying enough PPE to their health systems. Their stockpiles were not enough to prevent shortages, with many distribution problems resulting from inadequate governance mechanisms. No sustainable responses to supply disruptions were implemented during the study period in either case. Health systems planned interventions along each part of the supply chain from production and importing, to usage guidelines. Conclusion: Global supply chains are vulnerable to disruptions caused by international crises, and existing mitigation strategies have not been wholly successful. The existence of stockpiles is insufficient to preventing shortages of necessary equipment in clinical settings. Both the governance and quality of stockpiles, as well as distribution channels are important for preventing shortages. At the time of writing, it is not possible to judge the strength of strategies adopted in these cases.

scholarly journals Analysis of Droplet Splatter Patterns During Coblation Tonsil Surgery in the Covid-19 Pandemic

2021 ◽  
pp. 000348942110189
Author(s):  
Grace C. Khong ◽  
Jaya Bhat ◽  
Ravi S. Sharma ◽  
Samuel C. Leong
Keyword(s):  
Observational Study ◽  
Personal Protective Equipment ◽  
Mitigation Strategies ◽  
Head Model ◽  
Protective Equipment ◽  
Data Sets ◽  
Level Of Evidence ◽  
Tonsil Surgery ◽  
Surgical Field

Objectives: To assess droplet splatter around the surgical field and surgeon during simulated Coblation tonsil surgery to better inform on mitigation strategies and evaluate choice of personal protective equipment. Methods: This was an observational study performed using a life-size head model to simulate tonsil surgery and fluorescein-soaked strawberries to mimic tonsils. The Coblation wand was activated over the strawberries for 5 minutes. This was repeated 5 times with 2 surgeons (totalling 10 data sets). The presence of droplet around the surgical field and anatomical subsites on the surgeon was assessed in binary fashion: present or not present. The results were collated as frequency of droplet detection and illustrated as a heatmap; 0 = white, 1-2 = yellow, 3-4 = orange, and 5 = red. Results: Fluorescein droplets were detected in all 4 quadrants of the surgical field. The frequency of splatter was greatest in the upper (nearest to surgeon) and lower quadrants. There were detectable splatter droplets on the surgeon; most frequently occurring on the hands followed by the forearm. Droplets were also detected on the visor, neck, and chest albeit less frequently. However, none were detected on the upper arms. Conclusion: Droplet splatter can be detected in the immediate surgical field as well as on the surgeon. Although wearing a face visor does not prevent splatter on the surgical mask or around the eyes, it should be considered when undertaking tonsil surgery as well as a properly fitted goggle. Level of evidence: 5

Human factors–based risk analysis to improve the safety of doffing enhanced personal protective equipment

2018 ◽  
Vol 40 (2) ◽  
pp. 178-186 ◽  
Author(s):  
Ayse P. Gurses ◽  
Aaron S. Dietz ◽  
Elaine Nowakowski ◽  
Jennifer Andonian ◽  
Maggie Schiffhauer ◽  
...  
Keyword(s):  
Focus Group ◽  
Human Factors ◽  
Personal Protective Equipment ◽  
Failure Modes ◽  
Risk Mitigation ◽  
Mitigation Strategies ◽  
Protective Equipment ◽  
Contributing Factors ◽  
Safety Risks ◽  
Risk Mitigation Strategies

AbstractObjectiveTo systematically assess enhanced personal protective equipment (PPE) doffing safety risks.DesignWe employed a 3-part approach to this study: (1) hierarchical task analysis (HTA) of the PPE doffing process; (2) human factors-informed failure modes and effects analysis (FMEA); and (3) focus group sessions with a convenience sample of infection prevention (IP) subject matter experts.SettingA large academic US hospital with a regional Special Pathogens Treatment Center and enhanced PPE doffing protocol experience.ParticipantsEight IP experts.MethodsThe HTA was conducted jointly by 2 human-factors experts based on the Centers for Disease Control and Prevention PPE guidelines. The findings were used as a guide in 7 focus group sessions with IP experts to assess PPE doffing safety risks. For each HTA task step, IP experts identified failure mode(s), assigned priority risk scores, identified contributing factors and potential consequences, and identified potential risk mitigation strategies. Data were recorded in a tabular format during the sessions.ResultsOf 103 identified failure modes, the highest priority scores were associated with team members moving between clean and contaminated areas, glove removal, apron removal, and self-inspection while preparing to doff. Contributing factors related to the individual (eg, technical/ teamwork competency), task (eg, undetected PPE contamination), tools/technology (eg, PPE design characteristics), environment (eg, inadequate space), and organizational aspects (eg, training) were identified. Participants identified 86 types of risk mitigation strategies targeting the failure modes.ConclusionsDespite detailed guidelines, our study revealed 103 enhanced PPE doffing failure modes. Analysis of the failure modes suggests potential mitigation strategies to decrease self-contamination risk during enhanced PPE doffing.

Impact of COVID-19 on Nuclear Medicine in Germany, Austria and Switzerland: An International Survey in April 2020

2020 ◽  
Vol 59 (04) ◽  
pp. 294-299 ◽  
Author(s):  
Lutz S. Freudenberg ◽  
Ulf Dittmer ◽  
Ken Herrmann
Keyword(s):  
Nuclear Medicine ◽  
Health Systems ◽  
Personal Protective Equipment ◽  
Large Scale ◽  
Diagnostic Procedures ◽  
Protective Equipment ◽  
Current Crisis ◽  
Web Based ◽  
Public Versus Private ◽  
The Impact

Abstract Introduction Preparations of health systems to accommodate large number of severely ill COVID-19 patients in March/April 2020 has a significant impact on nuclear medicine departments. Materials and Methods A web-based questionnaire was designed to differentiate the impact of the pandemic on inpatient and outpatient nuclear medicine operations and on public versus private health systems, respectively. Questions were addressing the following issues: impact on nuclear medicine diagnostics and therapy, use of recommendations, personal protective equipment, and organizational adaptations. The survey was available for 6 days and closed on April 20, 2020. Results 113 complete responses were recorded. Nearly all participants (97 %) report a decline of nuclear medicine diagnostic procedures. The mean reduction in the last three weeks for PET/CT, scintigraphies of bone, myocardium, lung thyroid, sentinel lymph-node are –14.4 %, –47.2 %, –47.5 %, –40.7 %, –58.4 %, and –25.2 % respectively. Furthermore, 76 % of the participants report a reduction in therapies especially for benign thyroid disease (-41.8 %) and radiosynoviorthesis (–53.8 %) while tumor therapies remained mainly stable. 48 % of the participants report a shortage of personal protective equipment. Conclusions Nuclear medicine services are notably reduced 3 weeks after the SARS-CoV-2 pandemic reached Germany, Austria and Switzerland on a large scale. We must be aware that the current crisis will also have a significant economic impact on the healthcare system. As the survey cannot adapt to daily dynamic changes in priorities, it serves as a first snapshot requiring follow-up studies and comparisons with other countries and regions.

Infectious safety of nursing staff in departments (offices) functional diagnostics in the context of the COVID-19 pandemic

2020 ◽  
pp. 30-33
Author(s):  
E. V. Panina ◽  
M. V. Pugachev ◽  
A. G. Shchesiu
Keyword(s):  
Medical Care ◽  
Nursing Staff ◽  
Personal Protective Equipment ◽  
Medical Personnel ◽  
Medical Waste ◽  
Daily Activities ◽  
Protective Equipment ◽  
Functional Diagnostics ◽  
Prevention Of Infections ◽  
Epidemiological Situation

The article shows that in the daily activities of nursing staff of functional diagnostics departments (offices), it is necessary to strictly observe the requirements and rules for the prevention of infections associated with medical care, especially during the COVID-19 pandemic. The types of personal protective equipment (PPE) of medical personnel (MP), as well as current effective methods of disinfection, rules for collecting medical waste in a complex epidemiological situation are presented.

Recomendações de equipamentos de proteção individual no combate ao COVID-19

2020 ◽  
Vol 10 (31) ◽  
pp. 87-95
Author(s):  
Nicole Maria Miyamoto Bettini ◽  
Fabiana Tomé Ramos ◽  
Priscila Masquetto Vieira de Almeida
Keyword(s):  
World Health Organization ◽  
Personal Protective Equipment ◽  
Health Professionals ◽  
Health Personnel ◽  
Healthcare Professionals ◽  
World Health ◽  
Protective Equipment ◽  
Effective Strategy ◽  
The World ◽  
Health Organization

A Organização Mundial da Saúde - OMS confirmou a circulação internacional do novo Coronavírus em janeiro de 2020, nomeando-o como COVID-19 e, declarando uma pandemia. É de extrema importância que durante a pandemia, os profissionais de saúde tenham acesso e conhecimento sobre o uso correto dos Equipamentos de Proteção Individual (EPIs) e suas indicações, tomando assim, as devidas precauções na prevenção de infecções. O presente estudo buscou identificar a padronização mundial quanto ao uso dos EPIs utilizados no atendimento a pacientes suspeitos e/ou confirmados de COVID-19 no Brasil, EUA, China, Espanha, Itália e demais países europeus. Os guidelines apresentam a padronização quanto ao uso dos EPIs utilizados no atendimento a suspeitos e/ou confirmados de COVID-19, indo ao encontro das recomendações fornecidas pela OMS. Até o momento, o uso de EPIs é sem dúvida a estratégia mais importante e eficaz para proteger os profissionais de saúde durante a assistência ao paciente com COVID-19.Descritores: Infecções por Coronavírus, Equipamento de Proteção Individual, Pessoal de Saúde, Enfermagem. Recommendations for personal protective equipment to combat COVID-19Abstract: The World Health Organization - WHO confirmed the international circulation of the new Coronavirus in January 2020, naming it as COVID-19 and declaring a pandemic. It is extremely important that during the pandemic, health professionals have access and knowledge about the correct use of Personal Protective Equipment (PPE) and its indications, thus taking appropriate precautions to prevent infections. The present study sought to identify the worldwide standardization regarding the use of PPE utilized to take care of suspected and confirmed patients with COVID-19 in Brazil, USA, China, Spain, Italy and other European countries. The guidelines present a standardization regarding the use of PPE utilized to take care of suspected and confirmed with COVID-19, in line with the recommendations provided by WHO. To date, the use of PPE is undoubtedly the most important and effective strategy to protect healthcare professionals during care for patients with COVID-19.Descriptors: Coronavirus Infections, Personal Protective Equipment, Health Personnel, Nursing. Recomendaciones para el equipo de protección personal para combatir COVID-19Resumen: La Organización Mundial de la Salud - La OMS confirmó la circulación internacional del nuevo Coronavirus en enero de 2020, nombrándolo COVID-19 y declarando una pandemia. Es extremadamente importante que durante la pandemia, los profesionales de la salud tengan acceso y conocimiento sobre el uso correcto del Equipo de Protección Personal (EPP) y sus indicaciones, tomando así las precauciones adecuadas para prevenir infecciones. El presente estudio buscó identificar la estandarización mundial con respecto al uso de EPP utilizado para atender a pacientes sospechosos y/o confirmados con COVID-19 en Brasil, Estados Unidos, China, España, Italia y otros países europeos. Las pautas presentan la estandarización con respecto al uso de EPP utilizado para cuidar COVID-19 sospechoso y/o confirmado, de acuerdo con las recomendaciones proporcionadas por la OMS. Hasta la fecha, el uso de EPP es, sin duda, la estrategia más importante y efectiva para proteger a los profesionales de la salud durante la atención de pacientes con COVID-19.Descriptores: Infecciones por Coronavirus, Equipo de Protección Personal, Personal de Salud, Enfermería.

Sign in / Sign up

Export Citation Format

Share Document