A Prospective Clinical Evaluation of a Patient Isolation Hood During the COVID-19 Pandemic

BackgroundHealthcare workers have frequently become infected with SARS-CoV-2 whilst treating patients with COVID-19. A variety of novel devices have been proposed to reduce COVID-19 cross contamination.ObjectiveTo test whether a novel patient isolation hood was safe and comfortable, and could potentially reduce HCW COVID-19 infections.MethodsProspective cohort study of 20 patients, entailing staff/patient questionnaires, and safety aspects of prototype isolation hoods.Prospective collection of HCW COVID-19 data.Assessment of the hood’s safety and practicality, and adverse event reporting.Outcome MeasuresQuestionnaires’ responses, adverse events reporting, rates of HCW infections during study period (20/6/2020 −21/7/2020).HCW COVID-19 infections reported until last recorded HCW COVID-19 diagnosis (20/6/2020 −27/9/2020).ResultsOf the 60 (of 64) eligible individual staff surveys, 60 favoured isolation hood use.Staff were unanimous in: perceiving the hood as safe (60/60), preferring its use (56/56), and understanding its potential COVID-19 cross-contamination minimisation (60/60). All eight patients who completed the questionnaire thought the isolation hood helped prevent COVID-19 cross-infection, was safe, and comfortable. There were no reported patient safety adverse events. The overall attack COVID-19 attack rate from 20/6/2020-27/9/2020 among registered nurses was 3.4% (102/2994): ICUs 2.2% (3/138), Geriatric wards 13.2% (26/197), and COVID-19 Wards 18.3% (32/175). The COVID-19 attack rate among medical staff was: all junior medical staff 2.1% (24/932), senior medical staff 0.7% (4/607), aged care/rehabilitation 6.7% (2/30), and ICU all medical staff 8.6% (3/35).ConclusionsThe isolation hood was strongly endorsed by staff and patients, and post-study became part of standard ICU therapy. ICU nurse COVID-19 infection rates were low. ICU HCWs feel safer when treating patients with COVID-19 using an isolation hood.

SARS-CoV-2 Pandemic: A Review on Current Evidence and Unani Perspective

In December 2019, a novel coronavirus has emerged from the city Wuhan, China when cluster of pneumonia cases similar to viral pneumonia appeared, later named as SARS-CoV-2 virus, its symptomatology bears resemblance to Nazla-e-Wabāiya (epidemic influenza) in various treaties of Unani scholars. WHO on January 30, 2020 declared this outbreak as a public health emergency of international concern. To date, there are no specific vaccines or medicine for COVID-19 and the treatment is simply symptomatic. Therefore, prompt recognition of positive cases and rapid patient isolation may be needed to contain the disease spread to ensure timely management. Unani System of Medicine aims at preservation of health, management of diseases with a holistic approach. As per Unani classical literature, during epidemics prevention of disease and maintenance of health was achieved by strengthening the Ṭabī’at (Medicatrix Naturae) and modifications in Asbāb Sitta Darūriyya (Six Essential Factors).

Observed Time Burden With Isolation Precautions at Three University-Affiliated Hospitals in Korea

Background: Isolation precautions (IPs; ie, patient isolation with transmission-based precautions) are essential in hospital infection control interventions to prevent the transmission of healthcare-associated infections. Because IPs require healthcare personnel (HCP) to use personal protective equipment (PPE; eg, gown, gloves, and mask) to enter patient isolation rooms and perform hand hygiene (HH) frequently, IPs are often regarded as cumbersome tasks and may lead to fewer HCP visits. This observation study examined the time burden of IPs (ie, PPE use and HH) from time spent on HCP tasks, including patient treatment and care, in patient isolation rooms. Methods: With institutional review board approval, participating hospitals were recruited. At each hospital, assigned infection control nurses observed HCP tasks at patient isolation rooms of interest and recorded each task’s duration, using a stopwatch or timer and an observation form. For each observation block (ie, a duty period at 1 observation unit, regardless of the number of observed isolation rooms), unit-related information was collected, including the numbers of hospitalized patients, admission patients, discharge patients, isolation patients, and nurses. For each block, IP proportions were calculated by total time spent on IP divided by the total time spent on all tasks. Descriptive statistics, t test, ANOVA, and regression analyses were conducted using STATA version 16.0 software. Results: Three university-affiliated hospitals (838 average hospital beds, range 811–855) participated from April 2 to May 18, 2019 (for 7–9 days). In total, 2,901 tasks were monitored and the total time spent was 164,973 seconds; most tasks were done by nurses (89.2%) and females (86.8%). Although the most time-intensive task was procedures (eg, intravenous infusion) followed by medication, PPE use was the most frequent task followed by HH (Table 1). Regarding IP proportions, an overall average of 23.6% of total task time was spent on IPs (16.1% for PPE use and 7.5% for HH) in patient isolation rooms (Table 2). Notably, tasks in the tuberculosis isolation room of hospital B showed a greater HH proportion (13.7%) than PPE proportion (13.5%) because HCP usually use N95 masks only. Wards, compared to intensive care units (ICUs), showed higher PPE proportions (19.2%), potentially due to PPE stock in the nurse station and less PPE education compared to ICUs. Conclusions: Our study results demonstrated the substantial amount of time spent on IP compliance among all task durations in patient isolation rooms. To improve IP compliance, this time burden needs to be considered with greater system support, such as more nursing staff.Funding: This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (Grant no. 2017R1D1A1B03036377).Disclosures: None