scholarly journals Infection control in operating rooms for COVID-19 patients

2021 ◽  
Vol 64 (7) ◽  
pp. 491-498
Author(s):  
Seong Su Lee ◽  
Su Jin Kim ◽  
Jong Eun Jung ◽  
Gunn Hee Kim ◽  
Mi Young Kwon ◽  
...  
Keyword(s):  
High Risk ◽  
Infection Control ◽  
Personal Protective Equipment ◽  
Medical Staff ◽  
High Efficiency ◽  
Anesthetic Management ◽  
Patient Specific ◽  
Protective Equipment ◽  
Risk Of Infection ◽  
Very High

Background: Surgeries performed for patients with coronavirus disease 2019 (COVID-19) place the medical staff at very high risk of infection. We suggest recommendations for appropriate operation preparation, anesthetic management, and infection control for COVID-19 patients in operating rooms.Current Concepts: Surgeries must be performed in an airborne infection isolation room, such as a negative-pressure operating room. It is recommended that scheduled surgeries for COVID-19 patients be postponed to an acceptable extent, with the exception of emergency cases. Moreover, the number of medical staff participating in the surgery should be minimized. Medical staffs should practice proper hand hygiene and wear an appropriate level of personal protective equipment depending on the infection risk. While performing surgery and inducing anesthesia in COVID-19 patients, endotracheal intubation should be performed by trained anesthesiologists with a video laryngoscope, preferably using high-efficiency viral filters, which can prevent contamination in the anesthesia machine. Use of disposable equipment or COVID-19 patient-specific devices is recommended to prevent the spread of infection, but instruments that require sharing among multiple patients must be thoroughly cleaned and disinfected before their use for the next patient.Discussion and Conclusion: Medical staff performing surgeries for COVID-19 patients are at very high risk of infection. Therefore, the use of appropriate personal protective equipment, high-efficiency viral filters in breathing circuits during anesthesia, and disinfection of contaminated equipment after the operation are mandatory.

scholarly journals A mask-based infection control method for screening endoscopy may prevent SARS-CoV-2 transmission and relieve staff anxiety

2021 ◽  
Vol 9 ◽  
pp. 205031212110470
Author(s):  
Yuji Nadatani ◽  
Akira Higashimori ◽  
Shingo Takashima ◽  
Hirotsugu Maruyama ◽  
Koji Otani ◽  
...  
Keyword(s):  
High Risk ◽  
Infection Control ◽  
Personal Protective Equipment ◽  
Medical Staff ◽  
Fluorescent Dyes ◽  
Control Method ◽  
Protective Equipment ◽  
Health Checkup ◽  
Screening Endoscopy ◽  
Droplet Trajectory

Objectives: Endoscopy confers high risk for acquiring coronavirus disease 2019. Although guidelines recommend that medical staff use personal protective equipment, no infection control equipment have been established for patients. This study aimed to clarify the usefulness of two face masks we had designed for transnasal and transoral endoscopy. Methods: The efficacy of the masks was evaluated by simulating coughing in a mannequin with fluorescent dyes and mapping the droplet trajectory and number. The number of aerosols generated during endoscopy was clinically evaluated in the endoscopy room. Overall, 4356 screening endoscopies were performed with the patients wearing our masks at Medcity21, a health checkup facility, between June and December 2020; the effects of the masks on the patient’s condition were evaluated retrospectively. An 11-item paper-based survey was performed by the endoscopy staff 6 months after the adoption of the mask-based infection control method. Results: Use of both masks reduced the number of droplets released during the simulation. Clinically, the use of both masks did not affect the patients’ conditions during endoscopy and prevented an increase in the aerosols in the endoscopy room. This mask-based infection control method was favorably received, and all staff indicated that understanding the efficacy of our mask-based infection control reduced their anxiety regarding infection. Until December 2020, none of our staff had contracted SARS-CoV-2. Conclusion: Our mask-based infection control method is easy to adopt, inexpensive, and effective; understanding its effectiveness may help ease the fear of infection among endoscopy staff.

scholarly journals High-risk exposure without personal protective equipment and infection with SARS-CoV-2 in healthcare workers: results of the CoV-CONTACT prospective cohort

2020 ◽  
Author(s):  
Sarah Tubiana ◽  
Charles Burdet ◽  
Nadhira Houhou ◽  
Michael Thy ◽  
Pauline Manchon ◽  
...  
Keyword(s):  
High Risk ◽  
Personal Protective Equipment ◽  
Prospective Cohort ◽  
Healthcare Workers ◽  
Risk Exposure ◽  
Protective Equipment ◽  
Risk Of Infection ◽  
Rt Pcr ◽  
Specific Symptom ◽  
Increased Risk

Objective: We aimed to estimate the risk of infection in Healthcare workers (HCWs) following a high-risk exposure without personal protective equipment (PPE). Methods: We conducted a prospective cohort in HCWs who had a high-risk exposure to SARS-CoV-2-infected subject without PPE. Daily symptoms were self-reported for 30 days, nasopharyngeal swabs for SARS-CoV-2 RT-PCR were performed at inclusion and at days 3, 5, 7 and 12, SARS-CoV-2 serology was assessed at inclusion and at day 30. Confirmed infection was defined by positive RT-PCR or seroconversion, and possible infection by one general and one specific symptom for two consecutive days. Results: Between February 5th and May 30th, 2020, 154 HCWs were enrolled within 14 days following one high-risk exposure to either a hospital patient (70/154; 46.1%) and/or a colleague (95/154; 62.5%). At day 30, 25.0% had a confirmed infection (37/148; 95%CI, 18.4%; 32.9%), and 43.9% (65/148; 95%CI, 35.9%; 52.3%) had a confirmed or possible infection. Factors independently associated with confirmed or possible SARS-CoV-2 infection were being a pharmacist or administrative assistant rather than being from medical staff (adjusted OR (aOR)=3.8, CI95%=1.3;11.2, p=0.01), and exposure to a SARS-CoV-2-infected patient rather than exposure to a SARS-CoV-2-infected colleague (aOR=2.6, CI95%=1.2;5.9, p=0.02). Among the 26 HCWs with a SARS-CoV-2-positive nasopharyngeal swab, 7 (26.9%) had no symptom at the time of the RT-PCR positivity. Conclusions: The proportion of HCWs with confirmed or possible SARS-CoV-2 infection was high. There were less occurrences of high-risk exposure with patients than with colleagues, but those were associated with an increased risk of infection.

scholarly journals Ventilation mask adapted for endoscopy during the COVID-19 pandemic

2020 ◽  
Vol 66 (suppl 2) ◽  
pp. 55-57
Author(s):  
José Luiz Paccos ◽  
Ivandro Paulo de Lima ◽  
Viviane Rissio Borba de Lima ◽  
Natália Sayuri Mukai
Keyword(s):  
High Risk ◽  
Environmental Contamination ◽  
Personal Protective Equipment ◽  
Preventive Measures ◽  
Protective Equipment ◽  
Risk Of Infection ◽  
Poor Control ◽  
Contamination Control ◽  
Before And After ◽  
Risk Of Disease

SUMMARY In the context of the COVID-19 pandemic, endoscopy services must adopt preventive measures to maintain proper functioning due to a high risk of disease contagion. Triage protocols before and after the procedure, personal protective equipment, and environmental contamination control are some of the endoscopy society’s recommendations. However, the risk of infection may remain high due to poor control over the source of contamination.Using a combination of standardized supplies and accessories in a hospital, a ventilation mask adapted to be used in endoscopic procedures is proposed to reduce COVID-19 contamination.

scholarly journals Motivating factors of infection control in nurse practice

2018 ◽  
Vol 51 ◽  
pp. 02010
Author(s):  
Diana Platace ◽  
Inga Millere
Keyword(s):  
High Risk ◽  
Infection Control ◽  
Patient Care ◽  
Personal Protective Equipment ◽  
Structured Interview ◽  
Care Process ◽  
Protective Equipment ◽  
Motivating Factors ◽  
Health Maintenance ◽  
Control Rules

Hospitals in developed countries for more than 170 years have been studying and validating a variety of methods for staff motivation: education at work, distributed leaflets, seminars and lectures, provided the necessary equipment and personal protective equipment as well as surveillance and control provided by the hospital epidemiological service. No less important role nurses play in the motivation of psychological factors, such as attitudes, habits, stress and tolerance. Aim – to explore the motivating factors of infection control in nurse practice. The study used qualitative research method – structured interview (n = 36) and a quantitative study – questionnaires (n = 230). Questionnaires engaged 98 intensive care nurses and 132 surgical nurses. Results – most of the nurses (62.2%) regularly improved their knowledge of infection control. Infection control rules in their work regularly used 86.1% of respondents, while 13.9% of respondents irregularly applied infection control within the patient care process, posing a threat to their own health as well as to patient's health. Nurses noted several motivating factors for infection control, for example, the importance of the rules in patient care (94.3%), availability of infection control rules in the ward (92.6%), regular supervision provided by head nurse (84.8%), positive attitude of colleagues (80.4%), availability of the necessary equipment and personal protective equipment, understandable and simple rules for infection control, sufficient time for infection control in patient care, adequate infection control and surveillance in high risk units, provided by the hospital epidemiological service. The most frequently mentioned reasons for breaking the infection control rules were increased workload and burnout, as well as the lack of understanding of the importance of infection control in patients’ health maintenance and inappropriate attitude. Conclusions – the study suggests that in high-risk units there are different motivating factors of infection control, such as the necessary equipment and personal protective equipment, comprehensibility and accessibility of infection control rules, infection control and surveillance provided by the hospital epidemiological service. And at the same time, there are factors that disturb nurses’ motivation, such as an increased workload, lack of awareness of infection control in practice and inappropriate attitude.

scholarly journals Emergency exploratory laparotomy in a COVID-19 patient - A case report -

2020 ◽  
Vol 15 (4) ◽  
pp. 498-504
Author(s):  
Seong Su Lee ◽  
Ji Hyun Park ◽  
Gunn Hee Kim ◽  
Mi Young Kwon ◽  
Hee Yeong Kim ◽  
...  
Keyword(s):  
Duodenal Ulcer ◽  
Case Report ◽  
High Efficiency ◽  
Anesthetic Management ◽  
Exploratory Laparotomy ◽  
Anesthesia Machine ◽  
Protective Equipment ◽  
Perforated Duodenal Ulcer ◽  
Risk Of Infection ◽  
Mechanically Ventilated

Background: Surgeries in patients with coronavirus disease 2019 (COVID-19) put medical staff at a high risk of infection. We report the anesthetic management and infection control of a mechanically ventilated COVID-19 patient who underwent exploratory laparotomy for suspected duodenal ulcer perforation.Case: A 73-year-old man, mechanically ventilated for confirmed COVID-19, showed clinical and radiographic signs of a perforated duodenal ulcer, and he was transferred under sedation and intubation to a negative-pressure operating room. The operating and assistant staff wore personal protective equipment. High-efficiency particulate absorbing (HEPA) filters were inserted into the expiratory circuits of the anesthesia machine and portable ventilator. No participating staff contracted COVID-19, although the patient later died due to pneumonia.Conclusions: This report can contribute to establishing clinical guidelines for the surgical management and operation room setting of COVID-19 patients.

scholarly journals Safe On-Boat Resuscitation by Lifeguards in COVID-19 Era: A Pilot Study Comparing Three Sets of Personal Protective Equipment

2021 ◽  
pp. 1-7
Author(s):  
Roberto Barcala-Furelos ◽  
Cristian Abelairas-Gómez ◽  
Alejandra Alonso-Calvete ◽  
Francisco Cano-Noguera ◽  
Aida Carballo-Fazanes ◽  
...  
Keyword(s):  
Pilot Study ◽  
Cardiopulmonary Resuscitation ◽  
Severe Acute Respiratory Syndrome ◽  
Personal Protective Equipment ◽  
High Efficiency ◽  
Prehospital Care ◽  
Protective Equipment ◽  
Preparation Time

Abstract Introduction: On-boat resuscitation can be applied by lifeguards in an inflatable rescue boat (IRB). Due to Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-COV-2) and recommendations for the use of personal protective equipment (PPE), prehospital care procedures need to be re-evaluated. The objective of this study was to determine how the use of PPE influences the amount of preparation time needed before beginning actual resuscitation and the quality of cardiopulmonary resuscitation (CPR; QCPR) on an IRB. Methods: Three CPR tests were performed by 14 lifeguards, in teams of two, wearing different PPE: (1) Basic PPE (B-PPE): gloves, a mask, and protective glasses; (2) Full PPE (F-PPE): B-PPE + a waterproof apron; and (3) Basic PPE + plastic blanket (B+PPE). On-boat resuscitation using a bag-valve-mask (BVM) and high efficiency particulate air (HEPA) filter was performed sailing at 20km/hour. Results: Using B-PPE takes less time and is significantly faster than F-PPE (B-PPE 17 [SD = 2] seconds versus F-PPE 69 [SD = 17] seconds; P = .001), and the use of B+PPE is slightly higher (B-PPE 17 [SD = 2] seconds versus B+PPE 34 [SD = 6] seconds; P = .002). The QCPR remained similar in all three scenarios (P >.05), reaching values over 79%. Conclusion: The use of PPE during on-board resuscitation is feasible and does not interfere with quality when performed by trained lifeguards. The use of a plastic blanket could be a quick and easy alternative to offer extra protection to lifeguards during CPR on an IRB.

scholarly journals 478. Psychological Distress among Infectious Disease Physicians during the Response to the COVID-19 Outbreak in the Republic of Korea

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S305-S305
Author(s):  
Se Yoon Park ◽  
Bongyoung Kim ◽  
Dong Sik Jung ◽  
Sook In Jung ◽  
Won Sup Oh ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Psychological Distress ◽  
Infection Control ◽  
Personal Protective Equipment ◽  
Text Message ◽  
Disease Outbreaks ◽  
Maslach Burnout Inventory ◽  
Republic Of Korea ◽  
Protective Equipment ◽  
The Republic

Abstract Background This study aimed to investigate psychological distress among infectious disease (ID) physicians during the coronavirus disease (COVID-19) outbreak in the Republic of Korea. Methods Using an online-based survey link sent via text message and email, we conducted a survey from April 21 to 25, 2020, targeting all ID physicians currently working in ID (n = 265). The questionnaire was based on the Maslach Burnout Inventory-Human Services Survey and the Depression, Anxiety, and Stress Scales, and information was collected on factors protecting against psychological distress and difficulties in relation to COVID-19. Results Of 265 ID physicians, 115 (43.3%) responded, showing burnout (97, 90.4%), depression (20, 17.4%), anxiety (23, 20.0%), and stress (5, 4.3%). There were no differences in terms of distress between ID physicians who were directly involved in the care of patients with COVID-19 or not (Table 1). Greater than 50% of physicians valued their work and felt recognized by others, whereas < 10% indicated that sufficient human and financial support and private time had been provided during the outbreak. The most challenging issues concerned a lack of human resources for COVID-19 treatment or infection control, a shortage of personal protective equipment or airborne infection isolation rooms, pressure for research, and lack of guidelines for COVID-19 management (Figure 1). Table 1. Figure 1. Difficulties in response to the COVID-19 outbreak. Abbreviations: COVID-19, coronavirus disease 19; HCWs, healthcare workers; ICPs, infection control practitioners; IRB, Institutional Review Board; PPE, personal protective equipment Conclusion During the COVID-19 outbreak in the ROK, most respondents reported psychological distress. Preparing strategies for infectious disease outbreaks that support ID physicians is essential. Disclosures All Authors: No reported disclosures

scholarly journals Cost-effectiveness analysis of SARS-CoV-2 infection prevention strategies including pre-endoscopic virus testing and use of high risk personal protective equipment

Endoscopy ◽  
2020 ◽  
Author(s):  
Alanna Ebigbo ◽  
Christoph Römmele ◽  
Christina Bartenschlager ◽  
Selin Temizel ◽  
Elisabeth Kling ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
High Risk ◽  
Personal Protective Equipment ◽  
Infection Prevention ◽  
High Volume ◽  
Protective Equipment ◽  
Prevalence Rates ◽  
Prevention Strategies ◽  
Universal Testing ◽  
Asymptomatic Patients

Abstract Background Infection prevention strategies to protect healthcare workers in endoscopy units during the post-peak phase of the COVID-19 pandemic are currently under intense discussion. In this paper, the cost-effectiveness of routine pre-endoscopy testing and high risk personal protective equipment (PPE) is addressed. Method A model based on theoretical assumptions of 10 000 asymptomatic patients presenting to a high volume center was created. Incremental cost-effectiveness ratios (ICERs) and absolute costs per endoscopy were calculated using a Monte Carlo simulation. Results ICER values for universal testing decreased with increasing prevalence rates. For higher prevalence rates (≥ 1 %), ICER values were lowest for routine pre-endoscopy testing coupled with use of high risk PPE, while cost per endoscopy was lowest for routine use of high risk PPE without universal testing. Conclusion In general, routine pre-endoscopy testing combined with high risk PPE becomes more cost-effective with rising prevalence rates of COVID-19.

COVID-19 in schools: Infection control, personal protective equipment and the latest CPR advice

2020 ◽  
Vol 1 (3) ◽  
pp. 129-132
Author(s):  
Emma Hammett
Keyword(s):  
Infection Control ◽  
Personal Protective Equipment ◽  
Protective Equipment ◽  
Educational Settings

There are a number of challenges in order to safely return more children to school. Emma Hammett provides an overview of the latest guidance on infection control, personal protective equipment and CPR for educational settings.

scholarly journals Retrospective Study on Personal Protective Equipment During Pandemic Link to Outbreak of Carbpenem-Resistant Enterobacteriace

2021 ◽  
Vol 1 (S1) ◽  
pp. s9-s10
Author(s):  
Kenisha Evans ◽  
Jennifer LeRose ◽  
Angela Beatriz Cruz ◽  
Lavina Jabbo ◽  
Teena Chopra
Keyword(s):  
Retrospective Study ◽  
Infection Control ◽  
Personal Protective Equipment ◽  
Horizontal Transmission ◽  
Control Measures ◽  
Protective Equipment ◽  
Local Health ◽  
Infection Rates ◽  
Infection Control Measures ◽  
The Impact

Background: In 2019, according to the Centers for Disease Control and Prevention, carbapenem-resistant Enterobacteriaceae (CRE), had cost the lives of >35,000 patients, particularly the most virulent plasmid-mediated New Delhi metallo-β-lactamase (NDM). Although healthcare systems normally have strict surveillance and infection control measures for CRE, the rapid emergence of novel SAR-CoV-2 and COVID-19 led to a shortage of personal protective equipment (PPE) and medical supplies. As a result, routine infection practices, such as contact precautions, were violated. Studies have shown this depletion and shift in resources compromised the control of infections such CRE leading to rising horizontal transmission. Method: A retrospective study was conducted at a tertiary healthcare system in Detroit, Michigan, to determine the impact of PPE shortages during the COVID-19 pandemic on NDM infection rates. The following periods were established during 2020 based on PPE availability: (1) pre-PPE shortage (January–June), (2) PPE shortage (July–October), and (3) post-PPE shortage (November–December). Rates of NDM per 10,000 patient days were compared between periods using the Wilcoxon signed rank-sum test. Isolates were confirmed resistant by NDM by molecular typing performed by the Michigan State Health Department. Patient characteristics were gathered by medical chart review and patient interviews by telephone. Results: Overall, the average rate of NDM infections was 1.82 ±1.5 per 10,000 patient days. Rates during the PPE shortage were significantly higher, averaging 3.6 ±1.1 cases per 10,000 patient days (P = .02). During this time, several infections occurred within patients on the same unit and/or patients with same treating team, suggesting possible horizontal transmission. Once PPE stock was replenished and isolation practices were reinstated, NDM infection rates decreased to 0.77 ±1.1 per 10,000 patient days. Conclusion: Control of CRE requires strategic planning with active surveillance, antimicrobial constructs, and infection control measures. The study illustrates that in times of crisis, such as the COVID-19 pandemic, the burden of effective infection control requires much more multidisciplinary efforts to prevent unintentional lapses in patient safety. A swift response by the state and local health departments at a tertiary-care healthcare center conveyed a positive mitigation of the highest clinical threats and decreased horizontal transmission of disease.Funding: NoDisclosures: None

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