scholarly journals Hospital beds and personal protective equipment planning for COVID-19 pandemic: A computer simulation approach

2020 ◽  
Author(s):  
Yiruo Lu ◽  
Yongpei Guan ◽  
Jennifer Fishe ◽  
Thanh Hogan ◽  
Xiang Zhong
Keyword(s):  
Computer Simulation ◽  
Personal Protective Equipment ◽  
Census Data ◽  
Discrete Event ◽  
Hospital Setting ◽  
Case Fatality ◽  
Protective Equipment ◽  
Simulation Approach ◽  
Number Of Patients ◽  
Hospital Resources

Abstract Health care systems are at the frontline to fight the COVID-19 pandemic. An emergent question for each hospital is how many general ward and intensive care unit beds are needed and how much personal protective equipment to be purchased. However, hospital pandemic preparedness has been hampered by a lack of sufficiently specific planning guidelines. In this paper, we developed a computer simulation approach to evaluating bed utilizations and the corresponding supply needs based on the operational considerations and constraints in individual hospitals. We built a data-driven SEIR model which is adaptive to control policies and can be utilized for regional forecast targeting a specific hospital’s catchment area. The forecast model was integrated into a discrete-event simulation which modeled the patient flow and the interaction with hospital resources. We tested the simulation model outputs against patient census data from UF Health Jacksonville, Jacksonville, FL. Simulation results were consistent with the observation that the hospital has ample bed resources to accommodate the regional COVID patients. After validation, the model was used to predict future bed utilizations given a spectrum of possible scenarios to advise bed planning and stockpiling decisions. Lastly, how to optimally allocate hospital resources to achieve the goal of reducing the case fatality rate while helping a maximum number of patients to recover was discussed. This decision support tool is tailored to a given hospital setting of interest and is generalizable to other hospitals to tackle the pandemic planning challenge.

scholarly journals Factors to Consider in the Use of Vital Signs Wearables to Minimize Contact With Stable COVID-19 Patients: Experience of Its Implementation During the Pandemic

2021 ◽  
Vol 3 ◽  
Author(s):  
Esther Monica Pei Jin Fan ◽  
Shin Yuh Ang ◽  
Ghee Chee Phua ◽  
Lee Chen Ee ◽  
Kok Cheong Wong ◽  
...  
Keyword(s):  
Personal Protective Equipment ◽  
Vital Signs ◽  
Healthcare Facility ◽  
Wearable Device ◽  
Protective Equipment ◽  
Healthcare Industry ◽  
Patient Contact ◽  
Vital Signs Monitoring ◽  
Number Of Patients ◽  
Patients Experience

The COVID-19 pandemic has created a huge burden on the healthcare industry worldwide. Pressures to increase the isolation healthcare facility to cope with the growing number of patients led to an exploration of the use of wearables for vital signs monitoring among stable COVID-19 patients. Vital signs wearables were chosen for use in our facility with the purpose of reducing patient contact and preserving personal protective equipment. The process of deciding on the wearable solution as well as the implementation of the solution brought much insight to the team. This paper presents an overview of factors to consider in implementing a vital signs wearable solution. This includes considerations before deciding on whether or not to use a wearable device, followed by key criteria of the solution to assess. With the use of wearables rising in popularity, this serves as a guide for others who may want to implement it in their institutions.

scholarly journals 824. Isolation Rounding - Enforcing Existing Isolation Policies to Conserve Personal Protective Equipment

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S454-S454
Author(s):  
Joshua K Schaffzin ◽  
Stephanie Herber ◽  
Nicole Kneflin ◽  
Matthew Frazier ◽  
Alyssa Paolella ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Personal Protective Equipment ◽  
Return On Investment ◽  
Effective Means ◽  
Pediatric Intensive Care ◽  
Nurse Educator ◽  
Protective Equipment ◽  
Time Period ◽  
Number Of Patients ◽  
Over Time

Abstract Background During the COVID-19 pandemic, supplies of personal protective equipment (PPE) have been limited and sold at increased cost. Prior to the pandemic, we had initiated a project to improve PPE adherence and decrease cost by removing eligible patients from transmission based precautions (TBPs). At baseline, ordering providers are responsible for TBP utilization with orders through the electronic medical record. We observed that patients were in TBP when not indicated; remained in TBP beyond the appropriate time; and a reluctance on the part of providers to discontinue the orders. We tested the effect on TBP duration and PPE utilization house-wide through frequent review of TBP by a nurse educator with communication to providers of discontinuation opportunities. Methods From November 2019 to February 2020, all TBP orders in the pediatric intensive care unit (PICU) were reviewed intermittently. In March 2020, review was expanded to all inpatients with daily reviews in all units. Changes recommended and completed were tracked for all reviewed patients. We estimated cost of PPE in the PICU over time based on the number of patients in isolation and type of TBP utilized to determine whether our intervention resulted in reduced PPE use. Results Regular rounding in the PICU increased the proportion of patients in appropriate TBP and reduced the need to communicate with providers directly (33% vs 3% requiring intervention, Figure 1). Over the same time period, less PPE was used and PPE-related costs lowered (average total PPE cost $306.18 vs $95.15 per day, Figure 2). Less of an effect was seen when analyzing house-wide data. Figure 1 - P-chart of Percent Interventions Among Patients in TBP Figure 2 - X-chart of Total PPE Cost in the ICU Conclusion Isolation rounds is an effective means to ensure proper TBP adherence and manage PPE use appropriately. Additional study is needed to confirm a return on investment, to account for variation among units, and to sustain COVID-19-influenced gains beyond the pandemic. Disclosures All Authors: No reported disclosures

scholarly journals The Impact of COVID-19 Vaccination on Anxiety Levels of Turkish Dental Professionals and Their Attitude in Clinical Care: A Cross-Sectional Study

2021 ◽  
Vol 18 (19) ◽  
pp. 10373
Author(s):  
Fatih Karayürek ◽  
Ahmet Taylan Çebi ◽  
Aydın Gülses ◽  
Mustafa Ayna
Keyword(s):  
Personal Protective Equipment ◽  
Clinical Care ◽  
Protective Equipment ◽  
Main Concern ◽  
Positive Effects ◽  
Number Of Patients ◽  
Anxiety Levels ◽  
Fear And Anxiety ◽  
The Impact ◽  
Dental Professionals

Background: The current study aimed to assess the anxiety and fear levels and the attitude towards clinical care, such as the use of personal protective equipment and number of patients examined, before and after COVID-19 vaccination among Turkish dental professionals. Methods: A questionnaire including socio-demographical characteristics and clinical data regarding the number of patients, the use of personal protective equipment, vaccine confidence interval, positive or negative COVID-19 diagnosis, and fear and anxiety levels were examined. Results: A total of 475 dentists (196 men and 279 women) participated. Overall, the vaccination had a positive effect on the decrease of fear and anxiety levels of dental professionals. It was observed that the number of interventional procedures significantly increased after vaccination. Besides that, the amount of personal protective equipment used in patients, especially after the vaccination, has decreased. Conclusion: Despite the positive effects of vaccination on the anxiety levels of dental professionals, protective measurements should further be the main concern, regardless of the vaccination status of both the dental professional and the patient.

scholarly journals Systematic review and meta-analysis of clinical outcomes of COVID-19 patients undergoing gastrointestinal endoscopy

2021 ◽  
Vol 14 ◽  
pp. 175628482110421
Author(s):  
Xiangzhou Tan ◽  
Jianping Guo ◽  
Zihua Chen ◽  
Alfred Königsrainer ◽  
Dörte Wichmann
Keyword(s):  
Systematic Review ◽  
Confidence Interval ◽  
Personal Protective Equipment ◽  
Gastrointestinal Endoscopy ◽  
Meta Analysis ◽  
Case Fatality ◽  
Cochrane Library ◽  
Protective Equipment ◽  
Procedural Success ◽  
The Impact

Background: The impact of gastrointestinal endoscopy on COVID-19 infection remains poorly investigated. We herein performed a systematic review and meta-analysis to evaluate the outcomes of COVID-19 in patients undergoing gastrointestinal endoscopy. Method: Ovid Medline, Ovid EMBASE, Ovid the Cochrane Library, and other electronic databases were searched until 30 November 2020 to identify publications with confirmed COVID-19 infection in patients undergoing gastrointestinal endoscopy. The primary outcomes were SARS-CoV-2 transmission, personal protective equipment use, rates of case fatality, complications, and procedural success. Results: A total of 18 articles involving 329 patients were included in this systematic review and meta-analysis. The overall basic reproduction rate is 0.37, while the subgroup results from Asia, Europe, and North America are 0.13, 0.44, and 0.33, respectively. The differences in personal protective equipment use between the positive transmission and non-transmission group are mainly in isolation gowns, N95 or equivalent masks, and goggles or face-shields. The rate of case fatality, complication, and procedural success are 0.17 (95% confidence interval = 0.02–0.38), 0.00 (95% confidence interval = 0.00–0.02), and 0.89 (95% confidence interval = 0.50–1.00), respectively. The fatality rate in Europe was the highest (0.23, 95% confidence interval = 0.04–0.50), which is significantly different from other continents ( p = 0.034). Conclusion: The risk of SARS-CoV-2 transmission within gastrointestinal endoscopy units is considerably low if proper use of personal protective equipment is applied. Similarly, a low fatality and complication rate, as well as a high procedural success rate, indicated that a full recovery of endoscopic units should be considered.

scholarly journals The impact of the COVID-19 pandemic on Polish orthopedics, in particular on the level of stress among orthopedic surgeons and the education process

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257289
Author(s):  
Łukasz Kołodziej ◽  
Dawid Ciechanowicz ◽  
Hubert Rola ◽  
Szymon Wołyński ◽  
Hanna Wawrzyniak ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Personal Protective Equipment ◽  
Negative Impact ◽  
Protective Equipment ◽  
Orthopedic Surgeons ◽  
Number Of Patients ◽  
The Impact ◽  
Care System

The Coronovirus Disease 2019 –(COVID-19) pandemic had a significant impact on the health care system and medical staff around the world. The orthopedic units were also subject to new restrictions and regulations. Therefore, the aim of our research was to assess how the COVID-19 pandemic affected orthopedic wards in the last year in Poland. We created an online survey, which was sent to 273 members of the Polish Society of Orthopedics and Traumatology. The survey contained 51 questions and was divided into main sections: Preparedness, Training, Stress, Reduction, Awareness. A total of 80 responses to the survey were obtained. In Preparedness section the vast majority of respondents (90%) replied, that they used personal protective equipment during the pandemic, however only 50% of the respondents indicated that their facility received a sufficient amount of personal protective equipment. Most of the respondents indicated that the pandemic negatively affected the quality of training of future orthopedists (69.4%) and that pandemic has had a negative impact on their operating skills (66,7%). In Reduction section most of the doctors indicated that the number of patients hospitalized in their departments decreased by 20–60% (61,2% respondents), while the number of operations performed decreased by 60–100% (60% respondents). The negative impact of pandemic on education was noticeable especially in the group of young orthopedic surgeons: 0–5 years of work experience (p = 0,029). Among the respondents, the level of stress increased over the last year from 4.8 to 6.9 (p <0.001). The greatest increase in the level of stress was observed among orthopedists working in country hospitals (p = 0,03). In section Awareness 36,3% of respondents feel well or very well informed about the latest Covid-19 regulations. In addition, most doctors (82.6%) believe that the Polish health care system was not well prepared to fight the pandemic and that the regulations applied so far are not sufficient to effectively fight the pandemic (66.2%). The COVID-19 pandemic has impact on orthopedics departments in Poland and negatively affected the quality of training of orthopedic surgeons and the level of stress.

Tracheostomy and Improvement in Utilization of Hospital Resources During SARS-CoV-2 Pandemic Surge

2021 ◽  
Author(s):  
Rachel Sier ◽  
Osita Onugha
Keyword(s):  
Resource Allocation ◽  
Critical Care ◽  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Care Physician ◽  
Protective Equipment ◽  
Early Tracheostomy ◽  
Medication Utilization ◽  
Prolonged Ventilation ◽  
Hospital Resources

The SARS-CoV-2 pandemic has affected millions across the world. Significant patient surges have caused severe resource allocation challenges in personal protective equipment, medications, and staffing. The virus produces bilateral lung infiltrates causing significant oxygen depletion and respiratory failure thus increasing the need for ventilators. The patients who require ventilation are often requiring prolonged ventilation and depleting hospital resources. Tracheostomy is often utilized in patients requiring prolonged ventilation, and early tracheostomy in critical care patients has been shown in some studies to improve a variety of factors including intensive care unit (ICU) length of stay, ventilation weaning, and decreased sedation medication utilization. In a patient surge setting, as long as adequate personal protective equipment (PPE) is available to minimize spread to healthcare workers, early tracheostomy may be a beneficial management of these patients. Decreasing sedative medication utilization may help prevent shortages in future waves of infection and improve patient-provider communication as patients are more alert. Tracheostomy care is easier than endotracheal intubation and may have decreased viral aerosolization risk, particularly if repeat intubation is necessary after a weaning trial. Additionally, tracheostomy patients can be monitored with less staff, decreasing total healthcare worker exposure to infection. To manage risk of exposure, coordination of ventilation controlled by an anesthesiologist or a critical care physician with a surgeon during the procedure can minimize aerosolization to the team. Risk management and resource allocation is of the utmost importance in any global crisis and procedures must be appropriately planned and benefits to patients, as well as minimized exposure to healthcare providers, must be considered. Early tracheostomy could be a beneficial procedure for severe SARS-CoV-2 patients to minimize long-term virus aerosolization and exposure for healthcare workers while decreasing sedation, allowing for earlier transfer out of the ICU, and improving hospital resource utilization.

scholarly journals Dentists’ Knowledge and Practice of the Notification Protocol of the Ministry of Health in Dealing With COVID-19: A Cross-Sectional Study in Khuzestan

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Mohammad Shooriabi ◽  
Sedigheh Modarres Mousavy
Keyword(s):  
Infection Control ◽  
Personal Protective Equipment ◽  
Control Method ◽  
Protective Equipment ◽  
Dental Clinic ◽  
Ministry Of Health ◽  
Dental Clinics ◽  
Attitude And Practice ◽  
Number Of Patients ◽  
Group Members

Background: The number of patients suffering coronavirus (COVID-19) is increasing worldwide, and given that there is now no vaccine against this virus, the best prevention technique is to observe health protocols and social distancing. This issue is of paramount importance in dentistry clinics. Objectives: The study aimed to evaluate the knowledge, attitude, and practice of dentists in Ahvaz regarding COVID-19. Methods: The study population encompassed all dentists who were the WhatsApp group members of the Iranian Dental Association in Ahvaz, Iran. The online questionnaire link was shared on the social network on October 1, and the member dentists were asked to answer the questionnaire addressing demographic characteristics, knowledge about the signs and symptoms of COVID-19 disease, virus transmission method, and infection control method. These items assessed the dentists’ attitude and practice in the treatment procedure of the COVID-19 patients. Results: Out of 227 group members, 171 dentists observed the questionnaire link, and 108 persons answered the questions. Most of the respondents were 40-49 years old and male. Moreover, 19% of the participants had dentistry specialization, 60% of the dentists had received no training on infection control in dentistry, 66% of these individuals had passed the COVID-19 training course, and 23% of the dentists believed that the COVID-19 incubation period was 7-14 days. Most of the dentists were aware of the symptoms of COVID-19 and the diagnosis techniques for patients with COVID-19. They correctly reported the disease transmission and the disease prevention methods in the dental clinic. The dentists acted differently in using personal equipment, and only 75% of these individuals used the N95 Mask during the treatment of patients. About 13% of the dentists did not study the protocol proposed by the Ministry of Health for reopening the dental clinic during the COVID-19 outbreak period. Conclusions: The Ahvazian dentists are aware of the symptoms of COVID-19, its transmission, and the infection control protocol in dental clinics. However, they did not fully observe the protocols on wearing personal protective equipment for themselves and clinic staff; hence, barriers to using personal protective equipment should be eliminated, and the implementation of the protocols in dental clinics should be monitored more strictly.

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