Understanding the physiological effects of wearing enhanced personal protective equipment while providing patient care

2019 ◽  
Vol 17 (6) ◽  
pp. 517-521 ◽  
Author(s):  
Julie Bulson, DNP, MPA, RN, NE-BC ◽  
Kenneth Shawl, BBA, RRT, NHDP-BC
Keyword(s):  
Blood Pressure ◽  
Body Temperature ◽  
Oxygen Saturation ◽  
Patient Care ◽  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Vital Signs ◽  
Protective Equipment ◽  
Physiological Effects ◽  
Significant Difference

Purpose: There is a lack of information regarding the physiological effects of healthcare workers performing patient care while wearing enhanced personal protective equipment (PPE). This study aimed to provide foundational data necessary to maintain the health and safety of healthcare workers while performing tasks wearing enhanced PPE related to patient care in a biocontainment unit.Design and method: This study is a descriptive study evaluating the physiological effects of conducting patient care while wearing enhanced PPE. Participant vital signs (blood pressure, body temperature, and oxygen saturation) were monitored pre-donning, throughout the transport, and post-doffing.Results: There is no statistically significant difference in the physiological measurements of any of the participants. The results consisted of: blood pressure (systolic p = 0.0659; diastolic p = 0.94345); oxygen saturation (p = 0.6233); and orally derived body temperature (p = 0.1093). Physical balance was subjectively measured by both the participant and the trained observer during the donning and doffing process. Results show no visible difference in balance between the donning period and the doffing period. Conclusion: This study demonstrated there were no physiological changes to the healthcare workers in this study performing patient care activities during patient transport and in a biocontainment unit while wearing the provided enhanced PPE. However, limitations of this study include: (1) it was conducted at one location within the Midwest; (2) with a small number of participants; and (3) only the enhanced ensemble of PPE was worn during testing. Therefore, the results may not be generalizable to other locations or levels of PPE.Clinical relevance: This study will help to guide assessment standards for healthcare workers providing care while wearing enhanced level PPE.

scholarly journals Effects of personal protective equipment on the physiological parameters of health care workers

2020 ◽  
Vol 18 (7) ◽  
pp. 37-39
Author(s):  
Varun Mahajan, MD ◽  
Karan Singla, MD ◽  
Kamal Kajal, MD ◽  
Shiv Soni, MD ◽  
Amarjyoti Hazarika, MD ◽  
...  
Keyword(s):  
Health Care ◽  
Emergency Management ◽  
Patient Care ◽  
Health Care Workers ◽  
Personal Protective Equipment ◽  
Physiological Parameters ◽  
Protective Equipment ◽  
Physiological Effects ◽  
Care Workers

We would like to add to the study, Understanding the physiological effects of wearing enhanced personal protective equipment while providing patient care by Bulson and Shawl from the November/December 2019 issue of Journal of Emergency Management.

scholarly journals Different perspectives of doctors and nurses about the continuation of usage of some of the protection measures after the end of the COVID-19 pandemic

2021 ◽  
Vol 72 (1) ◽  
pp. 40-46
Author(s):  
Marina Ruxandra Oțelea ◽  
Dana Mateș ◽  
Agripina Rașcu
Keyword(s):  
Personal Protective Equipment ◽  
Disease Transmission ◽  
Healthcare Workers ◽  
Online Survey ◽  
Care Delivery ◽  
Protective Equipment ◽  
Protection Measures ◽  
Significant Difference ◽  
The Future ◽  
Doctors And Nurses

Abstract The current pandemic pointed toward a revision of the protection measures against infectious diseases. For any given new pathogen against which human species showed no immunity, isolation and personal protection equipment proved to reduce disease transmission. In medical settings, when there is inevitable contact with infected patients, these preventive measures have undoubtedly change the process of care delivery. The study aims to investigate the opinion of the healthcare workers about the utilization of the personal protective equipment after the pandemic stops. For this purpose, we conducted an online survey about changes related to the COVID-19 pandemic. For the healthcare workers, the survey also included several questions related to personal protective equipment. A total of 512 responders, doctors, and nurses answered to the survey. We performed comparisons between these two categories of personnel using the χ test. Overall, the results show that doctors are keener to follow the recommendations for the personal protective equipment in the future; there was a statistically significant difference (p<0.001) for the usage of gloves and masks while examining febrile patients, and for the handwashing after the examination of each patient. The type of service (outpatient or inpatient procedures) and direct contact with a COVID-19 patient were other factors to modulate the responses regarding using personal protective equipment in the future. The fact that 14.06% of the responders did not consider it necessary to wash hands after examining each patient underlines the urgent need for safety education in all healthcare workers and nurses.

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 Physiological Impacts of Personal Protective Equipment on Health Care Workers

2021 ◽  
Vol 10 (1) ◽  
pp. 1
Author(s):  
Anum Arif ◽  
Ahsin Manzoor Bhatti ◽  
Akhter Hussain ◽  
Mohammad Tariq ◽  
Osama Hadi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Health Care ◽  
Oxygen Saturation ◽  
Respiratory Rate ◽  
Health Care Workers ◽  
Personal Protective Equipment ◽  
Protective Equipment ◽  
Care Workers ◽  
End Tidal ◽  
End Tidal Co2

Introduction: Since the outbreak of the Ebola virus, its design has constantly been evolving to serve the purpose of protection without hampering the efficiency. In a study conducted in 2019, before the advent of COVID 19, it was found that performing precarious laboratory or clinical works while wearing PPE involved various restrictions compared to the same work without PPE.  The objective of this study is to identify the influence of personal protective equipment on physiological parameters and the individual wellbeing of healthy workers. Methods: This Pilot Quasi-experimental study was performed on 12 volunteers fitting the inclusion criteria. Candidates were seated comfortably and their baseline resting pulse rate, respiratory rate, oxygen saturation via pulse oximeter, blood pressure, and End-tidal CO2 were recorded via a portable monitor. All candidates were asked to wear a KN95 mask along with a 3 ply mask over it and wear anti-fog goggles. All the above-mentioned parameters were recorded again after five minutes of comfortable sitting and ten minutes of brisk walk. Result:   Significant difference is found between resting EtCO2 and after wearing of PPE (P = 0 .044). After a brief exercise, the further rise in EtCO2 is also significant (P = 0.002).  There is no significant rise in pulse after wearing PPE (P = 0.092) but on exertion after wearing PPE, the rise in pulse is statistically significant (P = 0.002). The rest of the variables, such as the rise in respiratory rate, blood pressure, and fall in oxygen saturation rise has no statistical significance. Conclusion: Personal protective equipment has proven to rise in end-tidal carbon dioxide and tachycardia, which can lead to headache, dizziness, and respiratory discomfort. All of the factors can hamper the health care workers' performance and can adversely affect their efficiency.Keywords: covid-19, end tidal CO2, personal protective equipment, physiological 

scholarly journals Stress and Associated Factors among Frontline Healthcare Workers in the COVID-19 Epicenter of Da Nang City, Vietnam

2021 ◽  
Vol 18 (14) ◽  
pp. 7378
Author(s):  
Nhan Phuc Thanh Nguyen ◽  
Duong Dinh Le ◽  
Robert Colebunders ◽  
Joseph Nelson Siewe Fodjo ◽  
Trung Dinh Tran ◽  
...  
Keyword(s):  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Stress Component ◽  
Multivariable Analysis ◽  
Working Hours ◽  
Health Facilities ◽  
Protective Equipment ◽  
Laboratory Workers ◽  
Frontline Healthcare Workers ◽  
Second Wave

Frontline healthcare workers (HCWs) involved in the COVID-19 response have a higher risk of experiencing psychosocial distress amidst the pandemic. Between July and September 2020, a second wave of the COVID-19 pandemic appeared in Vietnam with Da Nang city being the epicenter. During the outbreak, HCWs were quarantined within the health facilities in a bid to limit the spread of COVID-19 to their respective communities. Using the stress component of the 21-item Depression, Anxiety and Stress Scale (DASS-21), we assessed the level of stress among HCWs in Da Nang city. Between 30 August and 15 September 2020, 746 frontline HCWs were recruited to fill in an online structured questionnaire. Overall, 44.6% of participants experienced increased stress and 18.9% severe or extremely severe stress. In multivariable analysis, increased stress was associated with longer working hours (OR = 1.012; 95% CI: 1.004–1.019), working in health facilities providing COVID-19 treatment (OR = 1.58, 95% CI: 1.04–2.39), having direct contact with patients or their bio-samples (physicians, nurses and laboratory workers; OR = 1.42, 95% CI: 1.02–1.99), low confidence in the available personal protective equipment (OR = 0.846; 95% CI: 0.744–0.962) and low knowledge on COVID-19 prevention and treatment (OR = 0.853; 95% CI: 0.739–0.986). In conclusion, many frontline HCWs experienced increased stress during the COVID-19 outbreak in Da Nang city. Reducing working time, providing essential personal protective equipment and enhancing the knowledge on COVID-19 will help to reduce this stress. Moreover, extra support is needed for HCWs who are directly exposed to COVID-19 patients.

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 Fit Testing Retrofitted Full-Face Snorkel Masks as a Form of Novel Personal Protective Equipment During the COVID-19 Pandemic

2021 ◽  
pp. 1-16
Author(s):  
Stephanie Toigo ◽  
Michel Jacques ◽  
Tarek Razek ◽  
Ewa Rajda ◽  
Sidney Omelon ◽  
...  
Keyword(s):  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Health Centre ◽  
Disease Outbreaks ◽  
Protective Equipment ◽  
Test Results ◽  
Passing Rate ◽  
Fit Testing ◽  
Full Face ◽  
Medical Grade

ABSTRACT Objective: Bottlenecks in the personal protective equipment (PPE) supply chain have contributed to shortages of PPE during the COVID-19 pandemic, resulting in fractures in the functionality of healthcare systems. This study was conducted with the aim of determining the effectiveness of retrofitted commercial snorkel masks as an alternative respirator for healthcare workers during infectious disease outbreaks. Methods: A retrospective analysis was performed, analyzing qualitative and quantitative fit test results of the retrofitted Aria Ocean Reef® full-face snorkeling mask on healthcare workers at the McGill University Health Centre between April-June 2020. Historical fit test results, using medical-grade respirators, for healthcare workers were also analyzed. Results: During the study period, 71 participants volunteered for fit testing, 60.6% of which were nurses. The overall fit test passing rate using the snorkel mask was 83.1%. Of the participants who did not previously pass fit testing with medical-grade respirators, 80% achieved a passing fit test with the snorkel respirator. Conclusions: The results suggest that this novel respirator may be an effective and feasible alternative solution to address PPE shortages, while still providing healthcare workers with ample protection. Additional robust testing will be required to ensure that respirator fit is maintained, after numerous rounds of disinfection.

scholarly journals Acoustic voice characteristics with and without wearing a facemask

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Duy Duong Nguyen ◽  
Patricia McCabe ◽  
Donna Thomas ◽  
Alison Purcell ◽  
Maree Doble ◽  
...  
Keyword(s):  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Protective Equipment ◽  
Mask Condition ◽  
Connected Speech ◽  
Significant Attenuation ◽  
Cepstral Peak Prominence ◽  
Vocal Intensity ◽  
Significant Change ◽  
The Voice

AbstractFacemasks are essential for healthcare workers but characteristics of the voice whilst wearing this personal protective equipment are not well understood. In the present study, we compared acoustic voice measures in recordings of sixteen adults producing standardised vocal tasks with and without wearing either a surgical mask or a KN95 mask. Data were analysed for mean spectral levels at 0–1 kHz and 1–8 kHz regions, an energy ratio between 0–1 and 1–8 kHz (LH1000), harmonics-to-noise ratio (HNR), smoothed cepstral peak prominence (CPPS), and vocal intensity. In connected speech there was significant attenuation of mean spectral level at 1–8 kHz region and there was no significant change in this measure at 0–1 kHz. Mean spectral levels of vowel did not change significantly in mask-wearing conditions. LH1000 for connected speech significantly increased whilst wearing either a surgical mask or KN95 mask but no significant change in this measure was found for vowel. HNR was higher in the mask-wearing conditions than the no-mask condition. CPPS and vocal intensity did not change in mask-wearing conditions. These findings implied an attenuation effects of wearing these types of masks on the voice spectra with surgical mask showing less impact than the KN95.

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